Healthcare Provider Details

I. General information

NPI: 1407765779
Provider Name (Legal Business Name): SCOTT CHRISTOPHER HISS LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 W LAKE COOK RD STE 105
BUFFALO GROVE IL
60089-2093
US

IV. Provider business mailing address

750 W LAKE COOK RD
BUFFALO GROVE IL
60089-2069
US

V. Phone/Fax

Practice location:
  • Phone: 847-814-5031
  • Fax:
Mailing address:
  • Phone:
  • 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:
Title or Position:
Credential:
Phone: