MEDICARE: DR. DEVIN WILLIAM BERCAW 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	101YM0800X	Mental Health Counselor	180012038	IL
2	101YP2500X	Professional Counselor	180012038	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	180012038	OTHER	IL	LICENSED CLINICAL PROFESSIONAL COUNSELOR

General Provider Information

NPI Number	:	1720538408
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEVIN WILLIAM BERCAW LCPC

Provider Business Mailing Address
First Line	:	655 W IRVING PARK RD APT 4304
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60613-6300
Country	:	US
Telephone Number	:	773-304-8723
Fax Number	:

Provider Business Practice Location Address
First Line	:	655 W IRVING PARK RD APT 4304
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60613-6300
Country	:	US
Telephone Number	:	773-304-8723
Fax Number	:

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

Provider Enumeration Date	:	10/06/2016
Last Update Date	:	04/17/2026

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