| Lee Wichman Lcpc Inc | |
|
655 W Irving Park Rd Suite 201 Chicago IL 60613-3123 | |
| (773) 575-6373 | |
| Not Available |
| Full Name | Lee Wichman Lcpc Inc |
|---|---|
| Speciality | Counselor |
| Location | 655 W Irving Park Rd, Chicago, Illinois |
| Authorized Official Name and Position | Lee Wichman (PRESIDENT) |
| Authorized Official Contact | 7735756373 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lee Wichman Lcpc Inc 655 W Irving Park Rd Suite 201 Chicago IL 60613-3123 Ph: (773) 575-6373 | Lee Wichman Lcpc Inc 655 W Irving Park Rd Suite 201 Chicago IL 60613-3123 Ph: (773) 575-6373 |
| NPI Number | 1336312511 |
|---|---|
| Provider Enumeration Date | 04/08/2008 |
| Last Update Date | 03/03/2025 |
| Medicare PECOS PAC ID | 5991225534 |
|---|---|
| Medicare Enrollment ID | O20250226000086 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336312511 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 180004864 (Illinois) | Primary |
| Provider Name | Lee Wichman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003824897 PECOS PAC ID: 6800316449 Enrollment ID: I20250226000107 |
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