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NPI Code Detail

MEDICARE: ELISABETH IHLENFELD LCPC

MEDICARE: ELISABETH IHLENFELD 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 Counselor180013337IL

General Provider Information

NPI Number : 1588110720
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELISABETH IHLENFELD LCPC
Provider Business Mailing Address
First Line : 159 N SANGAMON ST STE 200
Second Line :
City : CHICAGO
State : IL
Zip : 60607-2201
Country : US
Telephone Number : 312-834-7709
Fax Number :
Provider Business Practice Location Address
First Line : 159 N SANGAMON ST STE 200
Second Line :
City : CHICAGO
State : IL
Zip : 60607-2201
Country : US
Telephone Number : 312-834-7709
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2016
Last Update Date : 01/04/2023

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