Healthcare Provider Details

I. General information

NPI: 1750222972
Provider Name (Legal Business Name): JHOANNA VEGA ROCHA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 S STATE ROUTE 31 STE 4
MCHENRY IL
60050-3134
US

IV. Provider business mailing address

2038 N NICOLE LN
ROUND LAKE BEACH IL
60073-2288
US

V. Phone/Fax

Practice location:
  • Phone: 847-531-3477
  • Fax:
Mailing address:
  • Phone: 224-577-5297
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178.020842
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: