Healthcare Provider Details

I. General information

NPI: 1922430073
Provider Name (Legal Business Name): CHERYL L JOSEPH-LUKZ MA, LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2013
Last Update Date: 07/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 RAND RD
DES PLAINES IL
60016-3509
US

IV. Provider business mailing address

730 N WABASH AVE COURTYARD BUILDING
CHICAGO IL
60611-2514
US

V. Phone/Fax

Practice location:
  • Phone: 847-376-2100
  • Fax: 847-390-8214
Mailing address:
  • Phone: 312-573-8005
  • Fax: 312-573-7719

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180005190
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: