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NPI Code Detail

MEDICARE: MISS TAMARA STOLOVITZKY LPC

MEDICARE: MISS TAMARA STOLOVITZKY 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
1101Y00000XCounselor178021017IL

General Provider Information

NPI Number : 1245115641
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS TAMARA STOLOVITZKY LPC
Provider Business Mailing Address
First Line : 2108 N SAINT LOUIS AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60647-7373
Country : US
Telephone Number : 404-273-3865
Fax Number :
Provider Business Practice Location Address
First Line : 4141 N KEDZIE AVE STE 2
Second Line :
City : CHICAGO
State : IL
Zip : 60618-2479
Country : US
Telephone Number : 773-754-0577
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2025
Last Update Date : 08/06/2025

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