Healthcare Provider Details

I. General information

NPI: 1013590215
Provider Name (Legal Business Name): FALECHIA N TURMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2021
Last Update Date: 05/04/2021
Certification Date: 05/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5080 N ELSTON AVE
CHICAGO IL
60630-2459
US

IV. Provider business mailing address

7530 S LANGLEY AVE
CHICAGO IL
60619-2225
US

V. Phone/Fax

Practice location:
  • Phone: 312-783-1372
  • Fax:
Mailing address:
  • Phone: 773-865-0448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: