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NPI Code Detail

MEDICARE: TONYIA PATRICE WINSTON PHD

MEDICARE:   TONYIA PATRICE WINSTON  PHD
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
1101YA0400XAddiction (Substance Use Disorder) Counselor150.108052IL
2101YM0800XMental Health Counselor150.108052IL
3101YP1600XPastoral Counselor150.108052IL
4104100000XSocial Worker150.108052IL

General Provider Information

NPI Number : 1679439574
Entity Type Code : Individual
Provider Name (Legal Business Name) : TONYIA PATRICE WINSTON PHD
Provider Business Mailing Address
First Line : 1779 225TH ST
Second Line :
City : SAUK VILLAGE
State : IL
Zip : 60411-5604
Country : US
Telephone Number : 773-719-1680
Fax Number :
Provider Business Practice Location Address
First Line : 1779 225TH ST
Second Line :
City : SAUK VILLAGE
State : IL
Zip : 60411-5604
Country : US
Telephone Number : 773-719-1680
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2026
Last Update Date : 01/05/2026

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Directions to “ TONYIA PATRICE WINSTON PHD” Practice Location

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