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NPI Code Detail

MEDICARE: GINA K HINES LCPC

MEDICARE: GINA K HINES 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
1101YP2500XProfessional Counselor180008017IL

General Provider Information

NPI Number : 1508134495
Entity Type Code : Individual
Provider Name (Legal Business Name) : GINA K HINES LCPC
Provider Business Mailing Address
First Line : 1101 31ST ST STE 105
Second Line :
City : DOWNERS GROVE
State : IL
Zip : 60515-5535
Country : US
Telephone Number : 630-206-9123
Fax Number : 630-598-9123
Provider Business Practice Location Address
First Line : 1101 31ST ST STE 105
Second Line :
City : DOWNERS GROVE
State : IL
Zip : 60515-5535
Country : US
Telephone Number : 630-587-3777
Fax Number : 630-587-3179
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2011
Last Update Date : 09/25/2023

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