Healthcare Provider Details
I. General information
NPI: 1033021696
Provider Name (Legal Business Name): GIRASOL COUNSELING AND WELLNESS CENTER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
449 N FOREST AVE
HILLSIDE IL
60162-1348
US
IV. Provider business mailing address
449 N FOREST AVE
HILLSIDE IL
60162-1348
US
V. Phone/Fax
- Phone: 312-772-4744
- Fax:
- Phone: 312-772-4744
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
GUADALUPE
TREJO
Title or Position: OWNER
Credential: LCPC
Phone: 815-582-7441