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General NPI Number Information
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NPI Number | 1710360458
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Entity Type | Organization
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Legal Business Name | PATRICIA HARTHUN LCPC LTD
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Dates
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Enumeration Date | 06/30/2015
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Last Update Date | 06/30/2015
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Provider Practice Location Address
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Address Line | 10725 S WESTERN AVE 2ND FLOOR
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City | CHICAGO
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State | IL
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Zip | 60643-3135
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Country | US
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Telephone | 312-835-7976
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Fax | 773-239-9857
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Provider Business Mailing Address
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Address Line | 10725 S WESTERN AVE 2ND FLOOR
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City | CHICAGO
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State | IL
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Zip | 60643-3135
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Country | US
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Telephone | 312-835-7976
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Fax | 773-239-9857
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Authorized Official
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Title or Position | OWNER
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Name | PATRICIA HARTHUN
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Credential | LCPC
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Telephone | 312-835-7976
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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 | 180005415
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License Number State | IL
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