Healthcare Provider Details

I. General information

NPI: 1518393859
Provider Name (Legal Business Name): SHERYL LYNN URBAN LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2013
Last Update Date: 12/16/2024
Certification Date: 12/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

232 S BRUNER ST
HINSDALE IL
60521-3940
US

IV. Provider business mailing address

232 S BRUNER ST
HINSDALE IL
60521-3940
US

V. Phone/Fax

Practice location:
  • Phone: 708-745-4665
  • Fax:
Mailing address:
  • Phone: 312-848-2478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180.007966
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: