Provider Demographics
NPI:1861764276
Name:RICHKO, MEGHANN M (LPC)
Entity type:Individual
Prefix:
First Name:MEGHANN
Middle Name:M
Last Name:RICHKO
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 1:1441 CAMPBELL AVE
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-6638
Mailing Address - Country:US
Mailing Address - Phone:847-668-7332
Mailing Address - Fax:
Practice Address - Street 1:1441 CAMPBELL AVE
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-6638
Practice Address - Country:US
Practice Address - Phone:847-668-7332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-31
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178007798101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional