Healthcare Provider Details

I. General information

NPI: 1639765357
Provider Name (Legal Business Name): APRIL ROSE DIFATTA LCPILL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2020
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 S HIGHLAND AVE
LOMBARD IL
60148-5363
US

IV. Provider business mailing address

900 TECHNOLOGY WAY STE 320
LIBERTYVILLE IL
60048-5364
US

V. Phone/Fax

Practice location:
  • Phone: 630-728-1744
  • Fax:
Mailing address:
  • Phone: 847-680-2715
  • Fax: 847-680-3832

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178016585
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: