Organization · Type 2 NPI
Supportive Interventions LLC
Professional Counselor · Evergreen Park, IL
NPI number
1104675404
Active
Practice location
9730 S Western Ave
Evergreen Park, IL 60805-2814
Mailing address
21720 W Long Grove Rd Ste C
Deer Park, IL 60010-3752
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | None listed |
Professional Counselor: Definition to come...
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About NPI 1104675404
Supportive Interventions LLC's National Provider Identifier is 1104675404, issued on May 17, 2024. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Evergreen Park, IL. The record was last updated on Oct 21, 2025.