Healthcare Provider Details

I. General information

NPI: 1821992116
Provider Name (Legal Business Name): NATALIE BROOKE DONOVAN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

142 E ONTARIO ST STE 1000
CHICAGO IL
60611-5424
US

IV. Provider business mailing address

3421 N WOLCOTT AVE APT 2
CHICAGO IL
60657-1031
US

V. Phone/Fax

Practice location:
  • Phone: 312-312-9000
  • Fax:
Mailing address:
  • Phone: 269-270-4052
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number178.032789
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: