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NPI Code Detail

MEDICARE: LEANN SUDALTER-PERLMAN LCPC

MEDICARE: LEANN SUDALTER-PERLMAN 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 Counselor180006930IL

General Provider Information

NPI Number : 1487818894
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEANN SUDALTER-PERLMAN LCPC
Provider Business Mailing Address
First Line : 1623 N WESTERN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60647-5321
Country : US
Telephone Number : 773-446-7711
Fax Number :
Provider Business Practice Location Address
First Line : 1623 N WESTERN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60647-5321
Country : US
Telephone Number : 773-446-7711
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2008
Last Update Date : 06/17/2015

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Directions to “ LEANN SUDALTER-PERLMAN LCPC” Practice Location

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