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NPI Code Detail

MEDICARE: XICAGO THERAPY PLLC

MEDICARE: XICAGO THERAPY 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
1261QM0850XAdult Mental Health Clinic/Center
2261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1265360358
Entity Type Code : Organization
Provider Name (Legal Business Name) : XICAGO THERAPY PLLC
Provider Business Mailing Address
First Line : 1653 W 35TH ST
Second Line :
City : CHICAGO
State : IL
Zip : 60609-1309
Country : US
Telephone Number : 773-980-6784
Fax Number :
Provider Business Practice Location Address
First Line : 1653 W 35TH ST
Second Line :
City : CHICAGO
State : IL
Zip : 60609-1309
Country : US
Telephone Number : 773-980-6784
Fax Number :
Authorized Official
Title or Position : OWNER/MANAGER
Name : ANA CARMEN CHAVEZ
Credential : LCSW
Telephone Number : 773-963-4776
Provider Enumeration Date : 05/11/2026
Last Update Date : 05/11/2026

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Directions to “XICAGO THERAPY PLLC ” Practice Location

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