Healthcare Provider Details

I. General information

NPI: 1780327205
Provider Name (Legal Business Name): LISA M. GALLAGHER LCPC, PLLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2022
Last Update Date: 01/19/2026
Certification Date: 01/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3205 N WILKE RD STE 116
ARLINGTON HEIGHTS IL
60004-0001
US

IV. Provider business mailing address

3905 W NICHOLS RD
ARLINGTON HEIGHTS IL
60004-1388
US

V. Phone/Fax

Practice location:
  • Phone: 224-805-6817
  • Fax:
Mailing address:
  • Phone: 224-805-6817
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: LISA M GALLAGHER
Title or Position: THERAPIST
Credential: LCPC
Phone: 224-805-6817