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NPI Code Detail

MEDICARE: GRACE INTEGRATED, LLC

MEDICARE: GRACE INTEGRATED, LLC
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 Counselor180.008484IL

General Provider Information

NPI Number : 1689026148
Entity Type Code : Organization
Provider Name (Legal Business Name) : GRACE INTEGRATED, LLC
Provider Business Mailing Address
First Line : 414 PLAZA DR STE 301
Second Line :
City : WESTMONT
State : IL
Zip : 60559-5508
Country : US
Telephone Number : 630-313-9741
Fax Number :
Provider Business Practice Location Address
First Line : 414 PLAZA DR STE 301
Second Line :
City : WESTMONT
State : IL
Zip : 60559-5508
Country : US
Telephone Number : 630-313-9741
Fax Number :
Authorized Official
Title or Position : MEMBER
Name : MRS. JULIE MARIE MCDEVITT
Credential : LCPC
Telephone Number : 630-313-9741
Provider Enumeration Date : 07/08/2016
Last Update Date : 03/04/2025

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Directions to “GRACE INTEGRATED, LLC ” Practice Location

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