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General NPI Number Information
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NPI Number | 1245488782
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Entity Type | Individual
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Provider Name | LESLIE KAREN SANN L.C.P.C.
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Gender | Female
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Dates
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Enumeration Date | 09/08/2008
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Last Update Date | 09/08/2008
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Provider Practice Location Address
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Address Line | 2000 N RACINE AVE SUITE 2300
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City | CHICAGO
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State | IL
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Zip | 60614-4045
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Country | US
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Telephone | 312-409-0686
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Fax | 630-443-4677
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Provider Business Mailing Address
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Address Line | 2000 N RACINE AVE SUITE 2300
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City | CHICAGO
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State | IL
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Zip | 60614-4045
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Country | US
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Telephone | 312-409-0686
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Fax | 630-443-4677
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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 | 180-001604
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License Number State | IL
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