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General NPI Number Information
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NPI Number | 1316324312
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Entity Type | Individual
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Provider Name | MICHAEL HENDON LPC
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Gender | Male
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Dates
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Enumeration Date | 04/29/2015
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Last Update Date | 11/09/2020
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Provider Practice Location Address
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Address Line | 588 LINCOLN AVE STE 200
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City | WINNETKA
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State | IL
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Zip | 60093-2308
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Country | US
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Telephone | 773-681-9212
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Fax |
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Provider Business Mailing Address
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Address Line | 588 LINCOLN AVE STE 200
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City | WINNETKA
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State | IL
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Zip | 60093-2308
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Country | US
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Telephone | 773-681-9212
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071.010385
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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 | 178.009285
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License Number State | IL
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