Healthcare Provider Details

I. General information

NPI: 1235954942
Provider Name (Legal Business Name): MS. SOPHIE HUTCHISON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2024
Last Update Date: 11/18/2024
Certification Date: 11/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 E OGDEN AVE STE 220
HINSDALE IL
60521-3546
US

IV. Provider business mailing address

212 COE RD
CLARENDON HILLS IL
60514-1002
US

V. Phone/Fax

Practice location:
  • Phone: 630-325-5300
  • Fax:
Mailing address:
  • Phone: 630-408-3646
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: