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NPI Code Detail

MEDICARE: MR. MICHAEL VILLARREAL LCPC

MEDICARE: MR. MICHAEL VILLARREAL 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
1101YP2500XProfessional Counselor180010064IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1101YP2500XOTHERILCMS.GOV

General Provider Information

NPI Number : 1851721039
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MICHAEL VILLARREAL LCPC
Provider Business Mailing Address
First Line : 4001 N WOLCOTT AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60613-2411
Country : US
Telephone Number : 773-991-5762
Fax Number : 312-661-5235
Provider Business Practice Location Address
First Line : 4001 N WOLCOTT AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60613-2411
Country : US
Telephone Number : 773-789-9775
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/25/2013
Last Update Date : 06/12/2025

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