Healthcare Provider Details

I. General information

NPI: 1972689198
Provider Name (Legal Business Name): TERESE ROSALYN HEFTER LCPC CMADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TERESE FENIG

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1731 N MARCEY TERRY HEFTER ASSOCIATES LLC SUITE 535
CHICAGO IL
60614-5373
US

IV. Provider business mailing address

1731 N MARCEY TERRY HEFTER ASSOCIATES LLC SUITE 535
CHICAGO IL
60614-5373
US

V. Phone/Fax

Practice location:
  • Phone: 312-280-1166
  • Fax: 312-280-1199
Mailing address:
  • Phone: 312-280-1166
  • Fax: 312-280-1199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: