MEDICARE: STEPHANIE NICOLE BUONOCORE 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	180017082	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1821633389	OTHER	IL	NPI
2	1962696054	OTHER		PRACTICE NPI

General Provider Information

NPI Number	:	1821633389
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE NICOLE BUONOCORE LCPC

Provider Business Mailing Address
First Line	:	4800 N SCOTTSDALE RD STE 2500
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85251-7630
Country	:	US
Telephone Number	:	630-428-7890
Fax Number	:

Provider Business Practice Location Address
First Line	:	3976 N AVONDALE AVE FL 2
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60641-2900
Country	:	US
Telephone Number	:	312-319-4162
Fax Number	:

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

Provider Enumeration Date	:	11/08/2019
Last Update Date	:	10/23/2025

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