Healthcare Provider Details

I. General information

NPI: 1457013377
Provider Name (Legal Business Name): CAITLIN LISCHKA LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2021
Last Update Date: 10/07/2021
Certification Date: 10/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 W HIGGINS RD STE 190
HOFFMAN ESTATES IL
60169-7252
US

IV. Provider business mailing address

1579 W RUE JAMES PL
PALATINE IL
60067-1223
US

V. Phone/Fax

Practice location:
  • Phone: 847-542-9777
  • Fax:
Mailing address:
  • Phone: 847-542-9777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178.015381
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: