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NPI Code Detail

MEDICARE: NIKKI M. JOVICILO LCPC

MEDICARE: NIKKI M. JOVICILO 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
1101Y00000XCounselor180.010117IL
2101YP2500XProfessional Counselor180.010117IL
3101YM0800XMental Health Counselor180.010117IL

General Provider Information

NPI Number : 1346671252
Entity Type Code : Individual
Provider Name (Legal Business Name) : NIKKI M. JOVICILO LCPC
Provider Business Mailing Address
First Line : 5350 W CARMEN AVE APT 2
Second Line :
City : CHICAGO
State : IL
Zip : 60630-2224
Country : US
Telephone Number : 773-492-0913
Fax Number : 708-249-0613
Provider Business Practice Location Address
First Line : 4849 N MILWAUKEE AVE STE 503
Second Line :
City : CHICAGO
State : IL
Zip : 60630-2191
Country : US
Telephone Number : 773-492-0913
Fax Number : 708-249-0613
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2013
Last Update Date : 12/09/2021

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