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NPI Code Detail

MEDICARE: MAIRA ANNE EGAN LPC, ATR-P

MEDICARE: MAIRA ANNE EGAN LPC, ATR-P
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
1221700000XArt Therapist
2101YP2500XProfessional Counselor178.021294IL

General Provider Information

NPI Number : 1528784543
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAIRA ANNE EGAN LPC, ATR-P
Provider Business Mailing Address
First Line : 2611 N ALBANY AVE APT 2
Second Line :
City : CHICAGO
State : IL
Zip : 60647-1667
Country : US
Telephone Number : 773-865-4193
Fax Number :
Provider Business Practice Location Address
First Line : 1811 W NORTH AVE STE 402
Second Line :
City : CHICAGO
State : IL
Zip : 60622-0204
Country : US
Telephone Number : 312-819-7381
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2022
Last Update Date : 03/04/2025

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