MEDICARE: MICHAEL HENDON 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
1	103TC0700X	Clinical Psychologist	071.010385	IL
2	101YP2500X	Professional Counselor	178.009285	IL

General Provider Information

NPI Number	:	1316324312
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL HENDON LPC

Provider Business Mailing Address
First Line	:	588 LINCOLN AVE STE 200
Second Line	:
City	:	WINNETKA
State	:	IL
Zip	:	60093-2308
Country	:	US
Telephone Number	:	773-681-9212
Fax Number	:

Provider Business Practice Location Address
First Line	:	588 LINCOLN AVE STE 200
Second Line	:
City	:	WINNETKA
State	:	IL
Zip	:	60093-2308
Country	:	US
Telephone Number	:	773-681-9212
Fax Number	:

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

Provider Enumeration Date	:	04/29/2015
Last Update Date	:	11/09/2020

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Directions to “ MICHAEL HENDON LPC” Practice Location

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