MEDICARE: MS. BETH A TABACHKA MA, 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	180.004416	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	180.004416	OTHER	IL	DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION

General Provider Information

NPI Number	:	1902324460
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BETH A TABACHKA MA, LCPC

Provider Business Mailing Address
First Line	:	1408 SHORE CT APT A1
Second Line	:
City	:	WHEELING
State	:	IL
Zip	:	60090-7101
Country	:	US
Telephone Number	:	847-476-1913
Fax Number	:

Provider Business Practice Location Address
First Line	:	115 N ARLINGTON HEIGHTS RD STE 102
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-6075
Country	:	US
Telephone Number	:	847-463-1055
Fax Number	:

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

Provider Enumeration Date	:	09/05/2017
Last Update Date	:	02/03/2026

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