MEDICARE: RYAN HESSLAU 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	101YM0800X	Mental Health Counselor	178.020367	IL

General Provider Information

NPI Number	:	1386481349
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYAN HESSLAU LPC

Provider Business Mailing Address
First Line	:	1470 SKYRIDGE DR UNIT 1
Second Line	:
City	:	CRYSTAL LAKE
State	:	IL
Zip	:	60014-8639
Country	:	US
Telephone Number	:	815-893-9873
Fax Number	:

Provider Business Practice Location Address
First Line	:	8600 US HIGHWAY 14 STE 110
Second Line	:
City	:	CRYSTAL LAKE
State	:	IL
Zip	:	60012-2700
Country	:	US
Telephone Number	:	815-861-9424
Fax Number	:

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

Provider Enumeration Date	:	07/09/2024
Last Update Date	:	03/21/2026

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