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General NPI Number Information
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NPI Number | 1316837941
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Entity Type | Individual
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Provider Name | PAIGE BROUILLETTE CORDER LPC
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Gender | Female
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Dates
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Enumeration Date | 07/07/2025
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Last Update Date | 07/07/2025
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Provider Practice Location Address
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Address Line | 444 N NORTHWEST HWY STE 320
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City | PARK RIDGE
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State | IL
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Zip | 60068-3277
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Country | US
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Telephone | 847-220-7298
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Fax |
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Provider Business Mailing Address
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Address Line | 8004 BROOKS RD
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City | CHARLESTOWN
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State | IN
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Zip | 47111-9797
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Country | US
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Telephone | 615-613-6937
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 178.021272
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License Number State | IL
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