MEDICARE: ANAYS LILIBETH GUZMAN LPC

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	101YP2500X	Professional Counselor	178.015222	IL

General Provider Information

NPI Number	:	1306497615
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANAYS LILIBETH GUZMAN LPC

Provider Business Mailing Address
First Line	:	125 WINDSOR DR
Second Line	:
City	:	OAK BROOK
State	:	IL
Zip	:	60523-1536
Country	:	US
Telephone Number	:	773-853-7441
Fax Number	:

Provider Business Practice Location Address
First Line	:	125 WINDSOR DR
Second Line	:
City	:	OAK BROOK
State	:	IL
Zip	:	60523-1536
Country	:	US
Telephone Number	:	630-728-1744
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2019
Last Update Date	:	09/27/2019

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