Healthcare Provider Details

I. General information

NPI: 1073444741
Provider Name (Legal Business Name): LILLY MICHELLE PARRA MAGGIO LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 E SUPERIOR ST STE 306
CHICAGO IL
60611-2595
US

IV. Provider business mailing address

3328 W LE MOYNE ST UNIT G
CHICAGO IL
60651-2610
US

V. Phone/Fax

Practice location:
  • Phone: 312-754-9404
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178.022915
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: