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NPI 1881004752

NPI 1881004752 : JOESEPH BYNUM : AURORA, IL

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General NPI Number Information
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    NPI Number           |    1881004752
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    Entity Type          |    Individual 
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    Provider Name        |    JOESEPH BYNUM
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/01/2014
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    Last Update Date     |    04/23/2025
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Provider Practice Location Address
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    Address Line         |    2527 CONGRESS AVE 
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    City                 |    AURORA
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    State                |    IL
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    Zip                  |    60503-6722
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    Country              |    US
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    Telephone            |    312-231-7212
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2527 CONGRESS AVE 
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    City                 |    AURORA
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    State                |    IL
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    Zip                  |    60503-6722
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    Country              |    US
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    Telephone            |    312-231-7212
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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       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    180013858
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    License Number State |    IL
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Taxonomy #3
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    Taxonomy Code        |    101YP2500X
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    Taxonomy Name        |    Professional Counselor
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    License Number       |    180013858
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    License Number State |    IL
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