MEDICARE: DAVID E BRIGGS 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	178007453	IL
2	101YM0800X	Mental Health Counselor	180008841	IL

General Provider Information

NPI Number	:	1356782759
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID E BRIGGS LPC

Provider Business Mailing Address
First Line	:	151 YOST AVE
Second Line	:
City	:	PARK RIDGE
State	:	IL
Zip	:	60068-5549
Country	:	US
Telephone Number	:	847-696-7324
Fax Number	:

Provider Business Practice Location Address
First Line	:	151 YOST AVE
Second Line	:
City	:	PARK RIDGE
State	:	IL
Zip	:	60068-5549
Country	:	US
Telephone Number	:	847-696-7324
Fax Number	:

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

Provider Enumeration Date	:	07/13/2013
Last Update Date	:	01/17/2014

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Directions to “ DAVID E BRIGGS LPC” Practice Location

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