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NPI Code Detail

MEDICARE: LUIS RESENDIZ LCPC

MEDICARE: LUIS RESENDIZ 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
1101YM0800XMental Health Counselor180015583IL

General Provider Information

NPI Number : 1639914492
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUIS RESENDIZ LCPC
Provider Business Mailing Address
First Line : 1854 S BLUE ISLAND AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60608-4686
Country : US
Telephone Number : 773-584-2224
Fax Number :
Provider Business Practice Location Address
First Line : 2627 W CERMAK RD
Second Line :
City : CHICAGO
State : IL
Zip : 60608-3514
Country : US
Telephone Number : 773-389-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2024
Last Update Date : 09/22/2025

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Directions to “ LUIS RESENDIZ LCPC” Practice Location

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