Healthcare Provider Details

I. General information

NPI: 1285498196
Provider Name (Legal Business Name): MICHAELA CLAIRE SOL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2024
Last Update Date: 02/12/2024
Certification Date: 02/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1232 CARYN TER
NORTHBROOK IL
60062-4607
US

IV. Provider business mailing address

1232 CARYN TER
NORTHBROOK IL
60062-4607
US

V. Phone/Fax

Practice location:
  • Phone: 773-355-8019
  • Fax:
Mailing address:
  • Phone: 773-355-8019
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178003603
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number227021694
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: