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General NPI Number Information
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NPI Number | 1578703922
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Entity Type | Organization
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Legal Business Name | EILEEN LANE, PC
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Dates
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Enumeration Date | 02/25/2009
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Last Update Date | 02/25/2009
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Provider Practice Location Address
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Address Line | 912 JULIAN CT
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City | NAPERVILLE
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State | IL
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Zip | 60540-7600
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Country | US
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Telephone | 630-452-4883
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Fax | 630-544-3740
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Provider Business Mailing Address
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Address Line | PO BOX 4193
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City | NAPERVILLE
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State | IL
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Zip | 60567-4193
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Country | US
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Telephone | 630-452-4883
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | EILEEN S. LANE
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Credential |
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Telephone | 630-452-4883
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180-002648
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License Number State | IL
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