Provider Demographics
NPI:1063032290
Name:FRISKE, LILY (LCPC)
Entity Type:Individual
Prefix:
First Name:LILY
Middle Name:
Last Name:FRISKE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 N GARY AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-4945
Mailing Address - Country:US
Mailing Address - Phone:630-484-5459
Mailing Address - Fax:
Practice Address - Street 1:900 S WABASH AVE APT 503
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-2224
Practice Address - Country:US
Practice Address - Phone:630-484-5459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-17
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional