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NPI Code Detail

MEDICARE: MARIA EROFEEVA LCPC

MEDICARE: MARIA EROFEEVA LCPC
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 Counselor180.015112IL

General Provider Information

NPI Number : 1285321711
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIA EROFEEVA LCPC
Provider Business Mailing Address
First Line : 3044 IMPERIAL OAKS DR
Second Line :
City : ROCKFORD
State : IL
Zip : 61114-5406
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 53 W JACKSON BLVD STE 520
Second Line :
City : CHICAGO
State : IL
Zip : 60604-3433
Country : US
Telephone Number : 815-543-0375
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2023
Last Update Date : 04/24/2023

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Directions to “ MARIA EROFEEVA LCPC” Practice Location

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