MEDICARE: DR. JOHN J. DEITCHE PH.D.

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	180000594	IL

General Provider Information

NPI Number	:	1982623989
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN J. DEITCHE PH.D.

Provider Business Mailing Address
First Line	:	20950 S FRANKFORT SQUARE RD STE A
Second Line	:
City	:	FRANKFORT
State	:	IL
Zip	:	60423-5125
Country	:	US
Telephone Number	:	708-361-6500
Fax Number	:

Provider Business Practice Location Address
First Line	:	20950 S FRANKFORT SQUARE RD STE A
Second Line	:
City	:	FRANKFORT
State	:	IL
Zip	:	60423-5125
Country	:	US
Telephone Number	:	708-361-6500
Fax Number	:

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

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	02/11/2026

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