Healthcare Provider Details

I. General information

NPI: 1205558400
Provider Name (Legal Business Name): MAUREEN CONWAY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2022
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 TRANS AM PLAZA DR 450
OAKBROOK TERRACE IL
60181
US

IV. Provider business mailing address

5550 TOUHY AVE STE 404
SKOKIE IL
60077-3227
US

V. Phone/Fax

Practice location:
  • Phone: 708-498-4364
  • Fax: 708-486-2702
Mailing address:
  • Phone: 847-329-9210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178.018057
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: