MEDICARE: MS. NAVDEEP SANDHU 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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	29009	IL
2	101YP2500X	Professional Counselor	180.008849	IL

General Provider Information

NPI Number	:	1700202173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NAVDEEP SANDHU LCPC

Provider Business Mailing Address
First Line	:	701 LEE ST
Second Line	:	SUITE 800
City	:	DES PLAINES
State	:	IL
Zip	:	60016-4539
Country	:	US
Telephone Number	:	847-795-3945
Fax Number	:

Provider Business Practice Location Address
First Line	:	3642 N DAMEN AVE APT 2R
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-4961
Country	:	US
Telephone Number	:	312-682-0023
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2014
Last Update Date	:	09/13/2021

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