Healthcare Provider Details

I. General information

NPI: 1285179820
Provider Name (Legal Business Name): BRANDON TESSERS LCPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2017
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1340 SHERMER RD STE 280
NORTHBROOK IL
60062-4589
US

IV. Provider business mailing address

1340 SHERMER RD STE 280
NORTHBROOK IL
60062-4589
US

V. Phone/Fax

Practice location:
  • Phone: 312-620-0217
  • Fax:
Mailing address:
  • Phone: 312-620-0217
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180.013285
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: