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NPI Code Detail

MEDICARE: NINA POLIGNONE LPC

MEDICARE: NINA POLIGNONE LPC
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
1106S00000XBehavior Technician
2101YP2500XProfessional Counselor178.016939IL

General Provider Information

NPI Number : 1982193108
Entity Type Code : Individual
Provider Name (Legal Business Name) : NINA POLIGNONE LPC
Provider Business Mailing Address
First Line : 15127 S 73RD AVE STE C
Second Line :
City : ORLAND PARK
State : IL
Zip : 60462-4398
Country : US
Telephone Number : 708-586-9303
Fax Number :
Provider Business Practice Location Address
First Line : 15127 S 73RD AVE STE C
Second Line :
City : ORLAND PARK
State : IL
Zip : 60462-3463
Country : US
Telephone Number : 630-225-8604
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2018
Last Update Date : 01/28/2022

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Directions to “ NINA POLIGNONE LPC” Practice Location

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