Provider Demographics
NPI:1144670183
Name:MARQUARDT, NDUNGE (LPC)
Entity type:Individual
Prefix:
First Name:NDUNGE
Middle Name:
Last Name:MARQUARDT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 PLAINFIELD RD
Mailing Address - Street 2:SUITE H
Mailing Address - City:WILLOWBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60527-7607
Mailing Address - Country:US
Mailing Address - Phone:630-269-2886
Mailing Address - Fax:
Practice Address - Street 1:535 PLAINFIELD RD
Practice Address - Street 2:SUITE H
Practice Address - City:WILLOWBROOK
Practice Address - State:IL
Practice Address - Zip Code:60527-7607
Practice Address - Country:US
Practice Address - Phone:630-269-2886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-21
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.011592101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional