Healthcare Provider Details

I. General information

NPI: 1891327870
Provider Name (Legal Business Name): MEAGAN COLLEEN MARY RESTAINO LCPC NCC CADC PCGC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2020
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15W437 GRAND PL
ELMHURST IL
60126-1378
US

IV. Provider business mailing address

PO BOX 135
BENSENVILLE IL
60106-0135
US

V. Phone/Fax

Practice location:
  • Phone: 630-283-2994
  • Fax:
Mailing address:
  • Phone: 630-283-2994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number180015628
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: