| Eileen H Glenn Ma Lcpc Llc | |
|
1740 Ridge Ave Suite 101b Evanston IL 60201-5918 | |
| (847) 733-9661 | |
| (847) 733-1571 |
| Full Name | Eileen H Glenn Ma Lcpc Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1740 Ridge Ave, Evanston, Illinois |
| Authorized Official Name and Position | Eileen H Glenn (OWNER) |
| Authorized Official Contact | 8477339661 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eileen H Glenn Ma Lcpc Llc 2209 Dodge Ave Evanston IL 60201-3012 Ph: (847) 733-1567 | Eileen H Glenn Ma Lcpc Llc 1740 Ridge Ave Suite 101b Evanston IL 60201-5918 Ph: (847) 733-9661 |
| NPI Number | 1952541948 |
|---|---|
| Provider Enumeration Date | 03/03/2009 |
| Last Update Date | 03/03/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952541948 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 180003470 (Illinois) | Primary |
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