MEDICARE: MRS. ALISON SCHILLING MCGANNON 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
1	101YP2500X	Professional Counselor	180006816	IL

General Provider Information

NPI Number	:	1568698355
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALISON SCHILLING MCGANNON LCPC

Provider Business Mailing Address
First Line	:	1619 W COLUMBIA AVE
Second Line	:	UNIT G
City	:	CHICAGO
State	:	IL
Zip	:	60626-4197
Country	:	US
Telephone Number	:	773-835-3366
Fax Number	:

Provider Business Practice Location Address
First Line	:	3047 N. LINCOLN AVE.
Second Line	:	SUITE 426
City	:	CHICAGO
State	:	IL
Zip	:	60657
Country	:	US
Telephone Number	:	773-835-3366
Fax Number	:

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

Provider Enumeration Date	:	06/07/2009
Last Update Date	:	03/15/2011

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