Healthcare Provider Details

I. General information

NPI: 1205574001
Provider Name (Legal Business Name): EVELYN PALOMO LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: EVELYN RAMIREZ LCPC

II. Dates (important events)

Enumeration Date: 05/23/2022
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 MATENA DR
OSWEGO IL
60543-8401
US

IV. Provider business mailing address

415 MATENA DR
OSWEGO IL
60543-8401
US

V. Phone/Fax

Practice location:
  • Phone: 630-995-3193
  • Fax:
Mailing address:
  • Phone: 630-329-1101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number178018061
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number180017977
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: