MEDICARE: SYDNEY HARRIS

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1821945783
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYDNEY HARRIS

Provider Business Mailing Address
First Line	:	PO BOX 1109
Second Line	:
City	:	DEKALB
State	:	IL
Zip	:	60115-7109
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12 HEALTH SERVICES DR
Second Line	:
City	:	DEKALB
State	:	IL
Zip	:	60115-9637
Country	:	US
Telephone Number	:	815-756-4875
Fax Number	:	815-756-2944

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

Provider Enumeration Date	:	03/11/2026
Last Update Date	:	03/11/2026

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Directions to “ SYDNEY HARRIS ” Practice Location

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