Individual provider · Type 1 NPI

Taylor Glen Shigeru Keoki Leisher

Mental Health Counselor · Chicago, IL

NPI number 1184267759 Active

Practice location

30 N Michigan Ave Ste 1609
Chicago, IL 60602-3652

Call (773) 683-3555 Map

Mailing address

862 N Marshfield Ave Apt 3F
Chicago, IL 60622-5137

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor 101YM0800XNone listed
Mental Health Counselor Primary 101YM0800X178015953 (IL)

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About NPI 1184267759

Taylor Glen Shigeru Keoki Leisher's National Provider Identifier is 1184267759, issued on Oct 25, 2019. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Chicago, IL. The record was last updated on Feb 2, 2023.