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General NPI Number Information
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NPI Number | 1821357047
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Entity Type | Individual
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Provider Name | MICHAEL V. HUGO A.C.S.W.
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Gender | Male
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Dates
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Enumeration Date | 05/08/2012
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Last Update Date | 05/08/2012
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Provider Practice Location Address
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Address Line | 505 E HAWLEY ST SUITE 140
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City | MUNDELEIN
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State | IL
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Zip | 60060-2494
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Country | US
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Telephone | 847-347-7367
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Fax | 224-513-4700
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Provider Business Mailing Address
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Address Line | 333 S PRAIRIE AVE
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City | MUNDELEIN
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State | IL
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Zip | 60060-2613
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Country | US
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Telephone | 847-322-7585
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149003414
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License Number State | IL
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