MEDICARE: WITNESS AND VALIDATE PLLC

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

General Provider Information

NPI Number	:	1558227124
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WITNESS AND VALIDATE PLLC

Provider Business Mailing Address
First Line	:	3166 N LINCOLN AVE STE 408
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-3174
Country	:	US
Telephone Number	:	847-877-7970
Fax Number	:

Provider Business Practice Location Address
First Line	:	3166 N LINCOLN AVE STE 408
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-3174
Country	:	US
Telephone Number	:	847-877-7970
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ PYSCHOTHERAPIST
Name	:	EMILY A PETROSCHUK
Credential	:	LCPC
Telephone Number	:	773-837-4488

Provider Enumeration Date	:	12/29/2025
Last Update Date	:	01/02/2026

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