MEDICARE: COFFEE TALK COUNSELING, INC.

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	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1548752355
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COFFEE TALK COUNSELING, INC.

Provider Business Mailing Address
First Line	:	1242 W PRATT BLVD APT 3F
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60626-4354
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3528 N ASHLAND AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-1314
Country	:	US
Telephone Number	:	773-250-1774
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SHARON ELLO
Credential	:	LCSW
Telephone Number	:	630-699-2747

Provider Enumeration Date	:	06/06/2018
Last Update Date	:	06/06/2018

Similar Medicare Providers

1699755751 — DR. ALAN DAVID WEILER O.D.
Practice Location Address:

3500 N ASHLAND AVE
CHICAGO, IL
60657-1314

Practice Phone: 773-327-0874
Practice Fax: 773-327-6535

1871692863 — LAKEVIEW EYECARE CENTER LTD
Practice Location Address:

3500 N ASHLAND AVE
CHICAGO, IL
60657-1314

Practice Phone: 773-327-0874
Practice Fax: 773-327-6535

1811535404 — SECURE DENTAL VI
Practice Location Address:

3540 N ASHLAND AVE
CHICAGO, IL
60657-1314

Practice Phone: 309-606-5008
Practice Fax:

1538896667 — UMAR PASHA DDS
Practice Location Address:

3540 N ASHLAND AVE
CHICAGO, IL
60657-1314

Practice Phone: 708-740-5972
Practice Fax:

1508855354 — DR. NIMA SANAI D.D.S.
Practice Location Address:

1514 W DEVON AVE
CHICAGO, IL
60660-1314

Practice Phone: 773-761-2521
Practice Fax: 773-761-2522

1982665204 — DR. REZA SANAI DDS, MS
Practice Location Address:

1514 W DEVON AVE
CHICAGO, IL
60660-1314

Practice Phone: 773-761-2521
Practice Fax: 773-761-2522

Directions to “COFFEE TALK COUNSELING, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.