MEDICARE: ERIN ELIZABETH DEBONO MS, ALMFT

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	106H00000X	Marriage & Family Therapist	208001197	IL

General Provider Information

NPI Number	:	1750116729
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN ELIZABETH DEBONO MS, ALMFT

Provider Business Mailing Address
First Line	:	53 W JACKSON BLVD STE 1501
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60604-3535
Country	:	US
Telephone Number	:	616-730-2660
Fax Number	:

Provider Business Practice Location Address
First Line	:	53 W JACKSON BLVD STE 1501
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60604-3535
Country	:	US
Telephone Number	:	224-268-1931
Fax Number	:

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

Provider Enumeration Date	:	09/07/2024
Last Update Date	:	09/14/2024

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