MEDICARE: MORGAN CONCEPCION, LCPC, LLC

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
1	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1568830156	OTHER		NPI
2	180.009959	OTHER	IL	LCPC LICENSE

General Provider Information

NPI Number	:	1235786880
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MORGAN CONCEPCION, LCPC, LLC

Provider Business Mailing Address
First Line	:	180 N MICHIGAN AVE STE 2410
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60601-7471
Country	:	US
Telephone Number	:	773-466-4239
Fax Number	:

Provider Business Practice Location Address
First Line	:	180 N MICHIGAN AVE STE 2410
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60601-7471
Country	:	US
Telephone Number	:	773-466-4239
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	MORGAN C CONCEPCION
Credential	:	LCPC
Telephone Number	:	773-466-4239

Provider Enumeration Date	:	08/19/2019
Last Update Date	:	08/19/2019

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