Individual provider · Type 1 NPI

Costa Provis, L.C.P.C.

Professional Counselor · Chicago, IL

NPI number 1679767826 Active

Practice location

444 N Michigan Ave
Chicago, IL 60611-3903

Call (847) 529-8607 Map

Mailing address

9430 Ozark Ave
Morton Grove, IL 60053-1063

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500XNone listed

Professional Counselor: Definition to come...

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About NPI 1679767826

Costa Provis, L.C.P.C.'s National Provider Identifier is 1679767826, issued on Aug 30, 2007. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Chicago, IL. The record was last updated on Aug 30, 2007.