=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356501571
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DR. EMBER MARIE PASTORE-HILLS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/11/2008
-----------------------------------------------------
Last Update Date | 08/09/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7120 WINDSOR LAKE PKWY
-----------------------------------------------------
City | LOVES PARK
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 61111-3803
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 815-877-9999
-----------------------------------------------------
Fax | 815-877-2601
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7120 WINDSOR LAKE PARKWAY
-----------------------------------------------------
City | LOVES PARK
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 61111-3803
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 815-877-9999
-----------------------------------------------------
Fax | 815-877-2601
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 178.002110
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------