Healthcare Provider Details

I. General information

NPI: 1326972480
Provider Name (Legal Business Name): EMILY WHITLOW LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 PARK PL STE 10
BOURBONNAIS IL
60914-1883
US

IV. Provider business mailing address

2267 MONARCH ST
BOURBONNAIS IL
60914-2781
US

V. Phone/Fax

Practice location:
  • Phone: 815-200-8518
  • Fax:
Mailing address:
  • Phone: 810-841-5829
  • Fax: 810-841-5829

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180.017460
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: