MEDICARE: BRENDA FLORES LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	178.021336	IL

General Provider Information

NPI Number	:	1033919204
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDA FLORES LPC

Provider Business Mailing Address
First Line	:	111 N WABASH AVE STE 1003
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60602-1902
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	77 W WASHINGTON ST STE 1506
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60602-3220
Country	:	US
Telephone Number	:	312-999-7114
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2025
Last Update Date	:	03/17/2025

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Directions to “ BRENDA FLORES LPC” Practice Location

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