| Doctor Name: | HANNAH GUPTON |
| NPI Number: | 1013376045 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S., L.P.C |
| License Number: | 178.010987 |
| Business Practice Address: | 5 Revere Dr Suite 100 Northbrook, IL - 600621566 |
| Business Phone Number: | 8472916805 |
| Business Fax Number: | |
| Mailing Address: | 5 Revere Dr, Suite 100 NORTHBROOK |
| State: | IL |
| Postal Code: | 600621566 |
| Phone Number: | 8472916805 |
| Fax Number: | |
| NPI Enumeration Date: | 02/18/2016 |
| NPI Last Update Date: | 02/18/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 178.010987 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |