Healthcare Provider Details

I. General information

NPI: 1497272769
Provider Name (Legal Business Name): LAKEFRONT COUNSELING GROUP, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2017
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 N MICHIGAN AVE STE 609
CHICAGO IL
60601-7506
US

IV. Provider business mailing address

155 N MICHIGAN AVE STE 609
CHICAGO IL
60601-7511
US

V. Phone/Fax

Practice location:
  • Phone: 847-942-2006
  • Fax: 312-239-6000
Mailing address:
  • Phone: 847-942-2006
  • Fax: 312-239-6000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number071006138
License Number StateIL

VIII. Authorized Official

Name: DR. ROBYNE FRANKFORT HOWARD
Title or Position: PSYCHOLOGIST, OWNER
Credential: PSY.D
Phone: 847-942-2006