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General NPI Number Information
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NPI Number | 1083508469
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Entity Type | Individual
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Provider Name | CAROLINE MCGANN HICKEY
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Gender | Female
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Dates
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Enumeration Date | 06/09/2025
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 1811 W NORTH AVE STE 402
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City | CHICAGO
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State | IL
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Zip | 60622-0204
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Country | US
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Telephone | 312-819-7381
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Fax | 312-428-3093
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Provider Business Mailing Address
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Address Line | 1811 W NORTH AVE STE 402
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City | CHICAGO
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State | IL
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Zip | 60622-0204
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Country | US
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Telephone | 312-210-0011
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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