Healthcare Provider Details

I. General information

NPI: 1093647117
Provider Name (Legal Business Name): DANIELLE HERRNDOBLER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

89 CEDAR AVE
LAKE VILLA IL
60046-8411
US

IV. Provider business mailing address

PO BOX 764
LAKE VILLA IL
60046-0764
US

V. Phone/Fax

Practice location:
  • Phone: 847-265-7300
  • Fax: 847-265-7301
Mailing address:
  • Phone: 847-265-7300
  • Fax: 847-265-7301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178023119
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: