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General NPI Number Information
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NPI Number | 1023148103
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Entity Type | Individual
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Provider Name | STEVE J. PLOUM M.A.
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Gender | Male
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 01/20/2016
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Provider Practice Location Address
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Address Line | 10540 S WESTERN AVE SUITE 506
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City | CHICAGO
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State | IL
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Zip | 60643-2536
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Country | US
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Telephone | 708-297-0102
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Fax | 773-614-8078
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Provider Business Mailing Address
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Address Line | 1418 WILLOW RD
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City | HOMEWOOD
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State | IL
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Zip | 60430-3437
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Country | US
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Telephone | 708-297-0102
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 180 002268
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License Number State | IL
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