Healthcare Provider Details

I. General information

NPI: 1477482347
Provider Name (Legal Business Name): TAYLOR HOUSING LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 5741
CHICAGO IL
60680-5741
US

IV. Provider business mailing address

PO BOX 5741
CHICAGO IL
60680-5741
US

V. Phone/Fax

Practice location:
  • Phone: 773-860-9264
  • Fax:
Mailing address:
  • Phone: 773-860-9264
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180016817
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: