Healthcare Provider Details

I. General information

NPI: 1508307026
Provider Name (Legal Business Name): MARGARET BURNS LCP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2017
Last Update Date: 09/09/2024
Certification Date: 09/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

437 SHERWOOD RD APT 1
LA GRANGE PARK IL
60526-2103
US

IV. Provider business mailing address

437 SHERWOOD RD APT 1
LA GRANGE PARK IL
60526-2103
US

V. Phone/Fax

Practice location:
  • Phone: 708-651-1109
  • Fax:
Mailing address:
  • Phone: 708-651-1109
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number178012926
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: