Healthcare Provider Details

I. General information

NPI: 1437817996
Provider Name (Legal Business Name): MEGAN WHITE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2021
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 S WASHINGTON ST STE 105
NAPERVILLE IL
60540-6665
US

IV. Provider business mailing address

8809 S 55TH CT
OAK LAWN IL
60453-1248
US

V. Phone/Fax

Practice location:
  • Phone: 630-206-4060
  • Fax:
Mailing address:
  • Phone: 708-927-1643
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number178.021589
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-21-184576
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: