Healthcare Provider Details

I. General information

NPI: 1114857646
Provider Name (Legal Business Name): TEA WITH TARA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

579 N 1ST BANK DR STE 150
PALATINE IL
60067-8102
US

IV. Provider business mailing address

579 N 1ST BANK DR STE 150
PALATINE IL
60067-8102
US

V. Phone/Fax

Practice location:
  • Phone: 224-324-1593
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: TARA CECELIA MURRAY
Title or Position: MANAGER
Credential: LCPC
Phone: 224-324-1593