Joanne Lagattolla, Pllc | |
1740 Ridge Ave Ste 109 Evanston IL 60201-5903 | |
(224) 764-1211 | |
(847) 483-5462 |
Full Name | Joanne Lagattolla, Pllc |
---|---|
Speciality | Counselor |
Location | 1740 Ridge Ave Ste 109, Evanston, Illinois |
Authorized Official Name and Position | Joanne Barbara Lagattolla (OWNER) |
Authorized Official Contact | 2247641211 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Joanne Lagattolla, Pllc 1226 S New Wilke Rd Apt 104 Arlington Heights IL 60005-2955 Ph: (224) 764-1211 | Joanne Lagattolla, Pllc 1740 Ridge Ave Ste 109 Evanston IL 60201-5903 Ph: (224) 764-1211 |
NPI Number | 1770210445 |
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Provider Enumeration Date | 08/03/2022 |
Last Update Date | 08/03/2022 |
Certification Date | 08/02/2022 |
Medicare PECOS PAC ID | 3375983679 |
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Medicare Enrollment ID | O20240503001520 |
Identifier | Type | State | Issuer |
---|---|---|---|
1770210445 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
Provider Name | Joanne Barbara Lagattolla |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1558848242 PECOS PAC ID: 7810337110 Enrollment ID: I20240503001635 |
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