Healthcare Provider Details

I. General information

NPI: 1760328280
Provider Name (Legal Business Name): MELISSA DEFRENZA-ISRAEL LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 W STATE ST STE 200
GENEVA IL
60134-4507
US

IV. Provider business mailing address

1079 WESTFIELD CRSE
GENEVA IL
60134-3462
US

V. Phone/Fax

Practice location:
  • Phone: 630-488-1421
  • Fax:
Mailing address:
  • Phone: 630-488-1421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180018200
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: