MEDICARE: MISS CYD C. ONEAL L.C.P.C.

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	101YM0800X	Mental Health Counselor	180005721	IL
2	101YP2500X	Professional Counselor	180005721	IL

General Provider Information

NPI Number	:	1376636944
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS CYD C. ONEAL L.C.P.C.

Provider Business Mailing Address
First Line	:	10137 S MORGAN ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60643-2222
Country	:	US
Telephone Number	:	773-307-7178
Fax Number	:	773-779-6526

Provider Business Practice Location Address
First Line	:	10137 S MORGAN ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60643-2222
Country	:	US
Telephone Number	:	312-402-1498
Fax Number	:

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

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	05/23/2024

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