Healthcare Provider Details

I. General information

NPI: 1346337649
Provider Name (Legal Business Name): NUNCIE E LYNCH M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15300 WEST AVE SUITE 313
ORLAND PARK IL
60462-4600
US

IV. Provider business mailing address

3129 W 98TH PL
EVERGREEN PARK IL
60805-3111
US

V. Phone/Fax

Practice location:
  • Phone: 708-460-2721
  • Fax:
Mailing address:
  • Phone: 708-422-9068
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number20383
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: