Healthcare Provider Details

I. General information

NPI: 1831020593
Provider Name (Legal Business Name): RJS3 COUNSELING AND CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

847 CHICAGO AVE UNIT 502
EVANSTON IL
60202-2382
US

IV. Provider business mailing address

847 CHICAGO AVE UNIT 502
EVANSTON IL
60202-2382
US

V. Phone/Fax

Practice location:
  • Phone: 630-336-5117
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TE1100X
TaxonomyExercise & Sports Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT JAMES SAMP III
Title or Position: PRACTICE OWNER
Credential: LCPC
Phone: 630-336-5117