Healthcare Provider Details
I. General information
NPI: 1760121958
Provider Name (Legal Business Name): HERE COMES THE SUN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/03/2022
Last Update Date: 06/03/2022
Certification Date: 06/01/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13246 S ROUTE 59 STE 220
PLAINFIELD IL
60585-9807
US
IV. Provider business mailing address
13246 S ROUTE 59 STE 220
PLAINFIELD IL
60585-9807
US
V. Phone/Fax
- Phone: 630-479-9581
- Fax:
- Phone: 630-479-9581
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
ALISON
TAYLOR
DULLI
Title or Position: CLINICAL THERAPIST/OWNER
Credential: LCPC
Phone: 630-479-9581