Healthcare Provider Details

I. General information

NPI: 1730780602
Provider Name (Legal Business Name): SABA AQEL LCPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2020
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 EMBLEM CIR UNIT 106
OSWEGO IL
60543-3451
US

IV. Provider business mailing address

1246 W PRATT BLVD APT 707
CHICAGO IL
60626-4386
US

V. Phone/Fax

Practice location:
  • Phone: 312-248-9475
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number178.015767
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180.016061
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: