1780669275 NPI number — JUDITH HILD M.A., LCPC

Table of content: JUDITH HILD M.A., LCPC (NPI 1780669275)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780669275 NPI number — JUDITH HILD M.A., LCPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HILD
Provider First Name:
JUDITH
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.A., LCPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1780669275
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
234 FORESTWAY DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTHBROOK
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60062-4809
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-498-0227
Provider Business Mailing Address Fax Number:
847-498-0858

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2150 PFINGSTEN RD
Provider Second Line Business Practice Location Address:
SUITE 2200
Provider Business Practice Location Address City Name:
GLENVIEW
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60026-1361
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-729-0332
Provider Business Practice Location Address Fax Number:
847-729-8852
Provider Enumeration Date:
12/07/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  180-002035 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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