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General NPI Number Information
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NPI Number | 1649695982
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Entity Type | Individual
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Provider Name | DARA ALTSHULER LPC
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Gender | Female
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Dates
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Enumeration Date | 02/24/2014
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 935 W CHESTNUT ST SUITE 201, URBAN BALANCE
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City | CHICAGO
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State | IL
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Zip | 60642-5441
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Country | US
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Telephone | 312-757-0043
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Fax | 312-226-9082
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Provider Business Mailing Address
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Address Line | 2325 N ORCHARD ST
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City | CHICAGO
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State | IL
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Zip | 60614-3303
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Country | US
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Telephone | 312-914-0801
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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 | 178009340
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License Number State | IL
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