Healthcare Provider Details

I. General information

NPI: 1710784467
Provider Name (Legal Business Name): CONSILIUM COUNSELING AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2025
Last Update Date: 05/09/2026
Certification Date: 05/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

477 E BUTTERFIELD RD STE 310-01
LOMBARD IL
60148-5618
US

IV. Provider business mailing address

477 E BUTTERFIELD RD STE 310-01
LOMBARD IL
60148-5618
US

V. Phone/Fax

Practice location:
  • Phone: 630-210-4813
  • Fax:
Mailing address:
  • Phone: 630-210-4813
  • 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 Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: TIFFANY HOAG
Title or Position: OWNER; THERAPIST
Credential: LCPC
Phone: 630-210-4813