Provider Demographics
NPI:1548697980
Name:CHASE COUNSELING & WELLNESS LTD.
Entity type:Organization
Organization Name:CHASE COUNSELING & WELLNESS LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHASE
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:847-271-7504
Mailing Address - Street 1:17727 W DARTMOOR DR
Mailing Address - Street 2:
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-1996
Mailing Address - Country:US
Mailing Address - Phone:847-271-7504
Mailing Address - Fax:
Practice Address - Street 1:100 N WAUKEGAN RD
Practice Address - Street 2:SUITE 204
Practice Address - City:LAKE BLUFF
Practice Address - State:IL
Practice Address - Zip Code:60044-1694
Practice Address - Country:US
Practice Address - Phone:847-271-7504
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-30
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.006404101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty