Healthcare Provider Details

I. General information

NPI: 1629530563
Provider Name (Legal Business Name): AMIE J BILSON LPC, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2019
Last Update Date: 01/03/2024
Certification Date: 01/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1147 W OHIO ST STE 103
CHICAGO IL
60642-5874
US

IV. Provider business mailing address

3909 BROOKSIDE DR
RAPID CITY SD
57702-2218
US

V. Phone/Fax

Practice location:
  • Phone: 312-772-9796
  • Fax:
Mailing address:
  • Phone: 412-638-7190
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number041374632
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178013492
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: