Healthcare Provider Details
I. General information
NPI: 1851073720
Provider Name (Legal Business Name): AOXUAN CAO
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/01/2023
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1440 W TAYLOR ST # 666
CHICAGO IL
60607-4623
US
IV. Provider business mailing address
1440 W TAYLOR ST # 666
CHICAGO IL
60607-4623
US
V. Phone/Fax
- Phone: 312-685-2508
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: