Healthcare Provider Details

I. General information

NPI: 1609358340
Provider Name (Legal Business Name): IRENE CHO, LCPC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2018
Last Update Date: 08/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 NAPERVILLE WHEATON RD STE 106
NAPERVILLE IL
60563-8454
US

IV. Provider business mailing address

1555 NAPERVILLE WHEATON RD STE 106
NAPERVILLE IL
60563-8454
US

V. Phone/Fax

Practice location:
  • Phone: 630-344-9390
  • Fax:
Mailing address:
  • Phone: 630-344-9390
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180-002325
License Number StateIL

VIII. Authorized Official

Name: MRS. IRENE CHO
Title or Position: LCPC
Credential: LCPC
Phone: 630-344-9390