person
Mr. Phillip Mark Licata, LCPC
Professional Counselor in Oak Brook, Illinois
NPI 1649493941

Phillip Mark Licata is a Professional Counselor based in Grayslake, IL and is specialized in Professional. Phillip Mark Licata practices in Oak Brook, IL and has the professional credentials of LCPC. The NPI Number for Phillip Mark Licata is 1649493941 and holds a License No. 180004784 (Illinois).

The current practice location address for Phillip Mark Licata is 1000 Jorie Blvd, Oak Brook, IL and can be reached out via phone at 847-951-0338.

Location: 1000 Jorie Blvd, Oak Brook, IL, 60030-2219
person
Provider Profile Details
NPI Number
1649493941
Provider Name
Phillip Mark Licata
Credential
LCPC
Provider Entity Type
Individual
Gender
Male
Address
1000 Jorie Blvd, Oak Brook, IL, 60030-2219
Phone Number
847-951-0338
Fax Number
Provider Enumeration Date
04/11/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1000 Jorie Blvd
City
State
Zip
60523-2214
Phone Number
847-951-0338
Fax Number
person
Provider Business Mailing Address Details
Address
1000 Jorie Blvd
City
State
Zip
60523-2214
Phone Number
847-951-0338
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
180004784 (Illinois)
Definition
Definition to come...
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