Healthcare Provider Details

I. General information

NPI: 1477181089
Provider Name (Legal Business Name): JULIE MUELLER, LCPC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2020
Last Update Date: 03/30/2020
Certification Date: 03/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16860 OAK PARK AVE STE 201
TINLEY PARK IL
60477-2008
US

IV. Provider business mailing address

16860 OAK PARK AVE STE 201
TINLEY PARK IL
60477-2008
US

V. Phone/Fax

Practice location:
  • Phone: 312-246-0465
  • Fax:
Mailing address:
  • Phone: 312-246-0465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. JULIE MUELLER
Title or Position: COUNSELOR
Credential: LCPC
Phone: 312-246-0465