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General NPI Number Information
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NPI Number | 1407484165
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Entity Type | Individual
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Provider Name | SANDY CHAVEZ LCPC
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Gender | Female
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Dates
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Enumeration Date | 03/30/2020
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Last Update Date | 09/15/2025
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Provider Practice Location Address
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Address Line | 5225 OLD ORCHARD RD STE 46
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City | SKOKIE
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State | IL
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Zip | 60077-1027
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Country | US
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Telephone | 847-231-3729
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Fax |
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Provider Business Mailing Address
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Address Line | 5225 OLD ORCHARD RD STE 46
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City | SKOKIE
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State | IL
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Zip | 60077-1027
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Country | US
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Telephone | 847-231-3729
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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 | C12078097831
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License Number State | IL
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