Organization Name: | ALLIANCE COUNSELING & COACHING OF ILLINOIS, LLC |
NPI Number: | 1063867257 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARYANN COOK (PRESIDENT/OWNER) |
Mailing Address: | 25224 W Eames St Channahon |
State: | IL US |
Postal Code: | 604105215 |
Phone Number: | 8154678181 |
Fax Number: | |
NPI Enumeration Date: | 04/26/2016 |
NPI Last Update Date: | 04/26/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 180006876 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |