Healthcare Provider Details

I. General information

NPI: 1386094878
Provider Name (Legal Business Name): LAUREN SCHIFFERDECKER LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2016
Last Update Date: 11/04/2024
Certification Date: 11/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 DUNDEE RD SUITE 101
NORTHBROOK IL
60062-2437
US

IV. Provider business mailing address

3100 DUNDEE RD SUITE 101
NORTHBROOK IL
60062-2437
US

V. Phone/Fax

Practice location:
  • Phone: 847-313-9490
  • Fax:
Mailing address:
  • Phone: 847-919-9096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180.009742
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: