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NPI Code Detail

MEDICARE: DANIELLE NICOLE PERTILLER LCPC

MEDICARE: DANIELLE NICOLE PERTILLER 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
1101YM0800XMental Health Counselor
2101YP2500XProfessional Counselor180013322IL

General Provider Information

NPI Number : 1780236240
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELLE NICOLE PERTILLER LCPC
Provider Business Mailing Address
First Line : 4800 N SCOTTSDALE RD STE 2500
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85251-7630
Country : US
Telephone Number : 630-428-7890
Fax Number :
Provider Business Practice Location Address
First Line : 1105 S WESTERN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60612-4146
Country : US
Telephone Number : 312-744-5809
Fax Number : 312-744-5809
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2019
Last Update Date : 11/05/2025

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Directions to “ DANIELLE NICOLE PERTILLER LCPC” Practice Location

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