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NPI Code Detail

MEDICARE: AMANDA JUE LCPC, NCC

MEDICARE: AMANDA JUE LCPC, 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
1101YP2500XProfessional Counselor180.016051IL

General Provider Information

NPI Number : 1285300863
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA JUE LCPC, NCC
Provider Business Mailing Address
First Line : 243 81ST ST
Second Line :
City : WILLOWBROOK
State : IL
Zip : 60527-2580
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 155 N MICHIGAN AVE STE 450
Second Line :
City : CHICAGO
State : IL
Zip : 60601-7939
Country : US
Telephone Number : 872-395-8091
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2021
Last Update Date : 08/13/2024

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