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General NPI Number Information
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NPI Number | 1497151617
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Entity Type | Individual
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Provider Name | SUSAN BACHARZ GUENTHER L.C.P.C.
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Gender | Female
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Dates
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Enumeration Date | 11/16/2014
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Last Update Date | 06/16/2015
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Provider Practice Location Address
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Address Line | 2530 CRAWFORD AVE STE 312 SUITE 312
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City | EVANSTON
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State | IL
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Zip | 60201-4972
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Country | US
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Telephone | 847-595-0603
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Fax |
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Provider Business Mailing Address
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Address Line | 420 LINDEN AVE APT. 204
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City | WILMETTE
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State | IL
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Zip | 60091-3608
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Country | US
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Telephone | 224-628-4514
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 180.008600
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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 | 180.008600
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License Number State | IL
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