MEDICARE: SHARONDA GILES LCPC

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	180.013015	IL
2	101YM0800X	Mental Health Counselor
3	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1225563943
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARONDA GILES LCPC

Provider Business Mailing Address
First Line	:	235 E 103RD ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60628-2807
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	235 E 103RD ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60628-2807
Country	:	US
Telephone Number	:	773-931-2431
Fax Number	:

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

Provider Enumeration Date	:	05/01/2017
Last Update Date	:	03/10/2026

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