Provider Demographics
NPI:1073022547
Name:RICHARDS, ISABELLE
Entity Type:Individual
Prefix:
First Name:ISABELLE
Middle Name:
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9239 GROSS POINT RD STE 300
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-1365
Mailing Address - Country:US
Mailing Address - Phone:312-608-6429
Mailing Address - Fax:
Practice Address - Street 1:9239 GROSS POINT RD STE 300
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-1365
Practice Address - Country:US
Practice Address - Phone:847-676-4447
Practice Address - Fax:847-676-4450
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-27
Last Update Date:2017-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180010934101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional