MEDICARE: CLOVER COUNSELING CHICAGO PLLC

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1194664300
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLOVER COUNSELING CHICAGO PLLC

Provider Business Mailing Address
First Line	:	452 W ROSLYN PL APT 2E
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-2742
Country	:	US
Telephone Number	:	815-715-7247
Fax Number	:

Provider Business Practice Location Address
First Line	:	452 W ROSLYN PL APT 2E
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-2742
Country	:	US
Telephone Number	:	815-715-7247
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KATHERINE ANN GROSS
Credential	:	LCPC
Telephone Number	:	815-715-7247

Provider Enumeration Date	:	03/25/2026
Last Update Date	:	03/25/2026

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