| Illumination Psychotherapy, Pllc | |
|
7300 N Cicero Ave Ste 102a Lincolnwood IL 60712-1641 | |
| (773) 318-7304 | |
| Not Available |
| Full Name | Illumination Psychotherapy, Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 7300 N Cicero Ave Ste 102a, Lincolnwood, Illinois |
| Authorized Official Name and Position | Garrett Shotwell (OWNER, CEO) |
| Authorized Official Contact | 7733187304 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Illumination Psychotherapy, Pllc 7300 N Cicero Ave Ste 102a Lincolnwood IL 60712-1641 Ph: (773) 318-7304 | Illumination Psychotherapy, Pllc 7300 N Cicero Ave Ste 102a Lincolnwood IL 60712-1641 Ph: (773) 318-7304 |
| NPI Number | 1013557644 |
|---|---|
| Provider Enumeration Date | 01/11/2020 |
| Last Update Date | 06/25/2020 |
| Certification Date | 06/25/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013557644 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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