MEDICARE: CHICAGO COUNSELING CENTER, P.C.

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

General Provider Information

NPI Number	:	1134062821
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHICAGO COUNSELING CENTER, P.C.

Provider Business Mailing Address
First Line	:	6140 N KILBOURN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60646-5020
Country	:	US
Telephone Number	:	773-932-9597
Fax Number	:	773-453-0519

Provider Business Practice Location Address
First Line	:	6160 N CICERO AVE STE 630
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60646-4325
Country	:	US
Telephone Number	:	773-932-9597
Fax Number	:	773-243-0519

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	MR. TAYLOR K NEWENDORP
Credential	:	MA, LCPC
Telephone Number	:	773-932-9597

Provider Enumeration Date	:	04/09/2026
Last Update Date	:	04/09/2026

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Directions to “CHICAGO COUNSELING CENTER, P.C. ” Practice Location

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