Healthcare Provider Details

I. General information

NPI: 1285342352
Provider Name (Legal Business Name): ERIC D WESTMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2022
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1616 E ROOSEVELT RD STE 8
WHEATON IL
60187-6850
US

IV. Provider business mailing address

15 S 10TH ST
SAINT CHARLES IL
60174-2627
US

V. Phone/Fax

Practice location:
  • Phone: 516-965-7471
  • Fax:
Mailing address:
  • Phone: 516-965-7471
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180018157
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: