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General NPI Number Information
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NPI Number | 1700417037
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Entity Type | Individual
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Provider Name | EILEEN MARIE RANCHARAN LPC
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Gender | Female
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Dates
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Enumeration Date | 01/27/2020
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Last Update Date | 01/27/2020
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Provider Practice Location Address
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Address Line | 977 LAKEVIEW PKWY STE 180
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City | VERNON HILLS
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State | IL
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Zip | 60061-1429
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Country | US
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Telephone | 847-245-1488
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Fax |
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Provider Business Mailing Address
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Address Line | 36404 N GRANDWOOD DR
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City | GURNEE
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State | IL
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Zip | 60031-1545
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Country | US
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Telephone | 708-580-6077
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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 | 178.015500
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License Number State | IL
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