Healthcare Provider Details

I. General information

NPI: 1669083846
Provider Name (Legal Business Name): ADRIANNA DEERING LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ADRIANNA GORA LPC

II. Dates (important events)

Enumeration Date: 08/12/2020
Last Update Date: 03/01/2022
Certification Date: 03/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 N MICHIGAN AVE STE 444
CHICAGO IL
60601-7511
US

IV. Provider business mailing address

4816 N HERMITAGE AVE APT 3F
CHICAGO IL
60640-4102
US

V. Phone/Fax

Practice location:
  • Phone: 312-278-3054
  • Fax:
Mailing address:
  • Phone: 630-788-8038
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178.015452
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: