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NPI Code Detail

MEDICARE: PORCHIA MITCHELL

MEDICARE: PORCHIA MITCHELL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor178016053IL

General Provider Information

NPI Number : 1194476226
Entity Type Code : Individual
Provider Name (Legal Business Name) : PORCHIA MITCHELL
Provider Business Mailing Address
First Line : 1860 W WINCHESTER RD STE 205
Second Line :
City : LIBERTYVILLE
State : IL
Zip : 60048-5317
Country : US
Telephone Number : 224-424-4194
Fax Number :
Provider Business Practice Location Address
First Line : 1860 W WINCHESTER RD STE 205
Second Line :
City : LIBERTYVILLE
State : IL
Zip : 60048-5317
Country : US
Telephone Number : 224-424-4194
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2022
Last Update Date : 01/11/2022

Similar Medicare Providers

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Directions to “ PORCHIA MITCHELL ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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