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NPI Code Detail

MEDICARE: ASTARA LILLIE HALL LCPC, CADC, NCC

MEDICARE: ASTARA LILLIE HALL LCPC, CADC, NCC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor33794IL
2101YP2500XProfessional Counselor180.012260IL

General Provider Information

NPI Number : 1255997987
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASTARA LILLIE HALL LCPC, CADC, NCC
Provider Business Mailing Address
First Line : 5440 N CAMPBELL AVE APT 1R
Second Line :
City : CHICAGO
State : IL
Zip : 60625-2235
Country : US
Telephone Number : 872-369-9807
Fax Number :
Provider Business Practice Location Address
First Line : 3501 N HALSTED ST
Second Line :
City : CHICAGO
State : IL
Zip : 60657-1832
Country : US
Telephone Number : 872-304-4401
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2019
Last Update Date : 05/15/2026

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