Provider Information for 1407477615
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MEGAN HEARY LCPC NCC CADC
Sex: Female
NPI: 1407477615
Last Updated: 2020-04-28
Certification Date: 2020-04-28
Certification Date: 2020-04-28
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1407477615 | ||||||||
| Enumeration Date | 2020-04-28 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 524 W DIVERSEY PKWY APT 2 CHICAGO, IL 60614-3937 United States Phone: 248-421-9839 | Fax: | ||||||||
| Primary Practice Address | 15419 E 127TH ST # 5 LEMONT, IL 60439-6494 United States Phone: 630-777-7113 | Fax: | ||||||||
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