MEDICARE: JUDITH HILD M.A., 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	180-002035	IL

General Provider Information

NPI Number	:	1780669275
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDITH HILD M.A., LCPC

Provider Business Mailing Address
First Line	:	234 FORESTWAY DR
Second Line	:
City	:	NORTHBROOK
State	:	IL
Zip	:	60062-4809
Country	:	US
Telephone Number	:	847-498-0227
Fax Number	:	847-498-0858

Provider Business Practice Location Address
First Line	:	2150 PFINGSTEN RD
Second Line	:	SUITE 2200
City	:	GLENVIEW
State	:	IL
Zip	:	60026-1361
Country	:	US
Telephone Number	:	847-729-0332
Fax Number	:	847-729-8852

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

Provider Enumeration Date	:	12/07/2005
Last Update Date	:	07/08/2007

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