Healthcare Provider Details

I. General information

NPI: 1780511600
Provider Name (Legal Business Name): YI SUN M.A., LPC, ATR-P
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

456 W FRONTAGE RD STE 224
NORTHFIELD IL
60093-3035
US

IV. Provider business mailing address

456 W FRONTAGE RD STE 224
NORTHFIELD IL
60093-3035
US

V. Phone/Fax

Practice location:
  • Phone: 312-978-1919
  • Fax:
Mailing address:
  • Phone: 312-978-1919
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number178.023157
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: