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General NPI Number Information
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NPI Number | 1306910062
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Entity Type | Individual
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Provider Name | MEGAN SHARE M.A., L.C.P.C.
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Gender | Female
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Dates
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Enumeration Date | 11/17/2006
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Last Update Date | 09/21/2011
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Provider Practice Location Address
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Address Line | 4747 W PETERSON AVE SUITE 409
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City | CHICAGO
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State | IL
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Zip | 60646-5712
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Country | US
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Telephone | 773-801-8701
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Fax | 866-514-1075
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Provider Business Mailing Address
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Address Line | 4747 W PETERSON AVE SUITE 409
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City | CHICAGO
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State | IL
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Zip | 60646-5712
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Country | US
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Telephone | 773-801-8701
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Fax | 866-514-1075
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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 | 180006708
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License Number State | IL
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