MEDICARE: CECILE M PETERMANN 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	178005885	IL

General Provider Information

NPI Number	:	1144466228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CECILE M PETERMANN LPC

Provider Business Mailing Address
First Line	:	115 S WILKE RD
Second Line	:	SUITE 300
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-1532
Country	:	US
Telephone Number	:	847-259-2020
Fax Number	:	847-259-2078

Provider Business Practice Location Address
First Line	:	115 S WILKE RD
Second Line	:	SUITE 300
City	:	ARLINGTON HTS
State	:	IL
Zip	:	60005-1532
Country	:	US
Telephone Number	:	847-259-2020
Fax Number	:	847-259-2078

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

Provider Enumeration Date	:	12/19/2008
Last Update Date	:	12/19/2008

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