Healthcare Provider Details

I. General information

NPI: 1215863394
Provider Name (Legal Business Name): BORGATTI PSYCHOTHERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 CHATHAM RD STE N
SPRINGFIELD IL
62704-4188
US

IV. Provider business mailing address

442 LONGCOMMON RD
RIVERSIDE IL
60546-1743
US

V. Phone/Fax

Practice location:
  • Phone: 708-820-3140
  • Fax:
Mailing address:
  • Phone: 312-351-4017
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MRS. GIULIA BORGATTI
Title or Position: MENTAL HEALTH COUNSELOR
Credential: LCPC
Phone: 312-351-4017