Healthcare Provider Details

I. General information

NPI: 1427615541
Provider Name (Legal Business Name): OUTREACH CAROL STREAM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2019
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

336 GUNDERSEN DR STE A
CAROL STREAM IL
60188-2403
US

IV. Provider business mailing address

373 S SCHMALE RD STE 102
CAROL STREAM IL
60188-2771
US

V. Phone/Fax

Practice location:
  • Phone: 630-871-2100
  • Fax: 630-588-0824
Mailing address:
  • Phone: 630-682-1910
  • Fax: 630-682-3094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: FEI YEE
Title or Position: DIRECTOR OF CLINICAL OPERATIONS
Credential: LMFT
Phone: 630-315-3050