MEDICARE: MARIKA YIP-BANNICQ 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	178.021804	IL

General Provider Information

NPI Number	:	1477432482
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIKA YIP-BANNICQ LPC

Provider Business Mailing Address
First Line	:	2535 W WINONA ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-2504
Country	:	US
Telephone Number	:	347-543-9697
Fax Number	:

Provider Business Practice Location Address
First Line	:	3717 N RAVENSWOOD AVE STE 211
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60613-4098
Country	:	US
Telephone Number	:	347-543-9697
Fax Number	:

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

Provider Enumeration Date	:	09/02/2025
Last Update Date	:	09/02/2025

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Directions to “ MARIKA YIP-BANNICQ LPC” Practice Location

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