MEDICARE: ARIEL HOMMES

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	150.014945	IL

General Provider Information

NPI Number	:	1881058691
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARIEL HOMMES

Provider Business Mailing Address
First Line	:	3113 W LAWRENCE AVE
Second Line	:	UNIT C201
City	:	CHICAGO
State	:	IL
Zip	:	60625-3656
Country	:	US
Telephone Number	:	312-613-6599
Fax Number	:

Provider Business Practice Location Address
First Line	:	3113 W LAWRENCE AVE
Second Line	:	UNIT C201
City	:	CHICAGO
State	:	IL
Zip	:	60625-3656
Country	:	US
Telephone Number	:	312-613-6599
Fax Number	:

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

Provider Enumeration Date	:	04/07/2016
Last Update Date	:	04/07/2016

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Directions to “ ARIEL HOMMES ” Practice Location

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