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NPI Code Detail

MEDICARE: MICHAEL JOSEPH VIVO LPC

MEDICARE: MICHAEL JOSEPH VIVO 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
1101YP2500XProfessional Counselor178021643IL

General Provider Information

NPI Number : 1205786795
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL JOSEPH VIVO LPC
Provider Business Mailing Address
First Line : 30 N MICHIGAN AVE STE 1622
Second Line :
City : CHICAGO
State : IL
Zip : 60602-3668
Country : US
Telephone Number : 773-873-7328
Fax Number :
Provider Business Practice Location Address
First Line : 30 N MICHIGAN AVE STE 1622
Second Line :
City : CHICAGO
State : IL
Zip : 60602-3668
Country : US
Telephone Number : 773-873-7328
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2026
Last Update Date : 02/02/2026

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Directions to “ MICHAEL JOSEPH VIVO LPC” Practice Location

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