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NPI 1073064911

NPI 1073064911 : LOVELY BINION : CHICAGO, IL

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General NPI Number Information
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    NPI Number           |    1073064911
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    Entity Type          |    Individual 
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    Provider Name        |    LOVELY BINION
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/15/2016
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    Last Update Date     |    01/30/2017
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Provider Practice Location Address
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    Address Line         |    2930 S MICHIGAN AVE 
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    City                 |    CHICAGO
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    State                |    IL
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    Zip                  |    60616-3270
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    Country              |    US
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    Telephone            |    773-819-5504
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2930 S MICHIGAN AVE 
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    City                 |    CHICAGO
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    State                |    IL
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    Zip                  |    60616-3270
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    Country              |    US
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    Telephone            |    773-819-5504
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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        |    101YP2500X
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    Taxonomy Name        |    Professional Counselor
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    License Number       |    178011343
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    License Number State |    IL
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Taxonomy #2
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    Taxonomy Code        |    101YP2500X
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    Taxonomy Name        |    Professional Counselor
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    License Number       |    329543
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    License Number State |    IL
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