Provider Demographics
NPI:1356647689
Name:KASTEL, ILENE S (MA, LCPC)
Entity Type:Individual
Prefix:
First Name:ILENE
Middle Name:S
Last Name:KASTEL
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 N MICHIGAN AVE STE 340
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-7444
Mailing Address - Country:US
Mailing Address - Phone:630-309-2044
Mailing Address - Fax:
Practice Address - Street 1:180 N MICHIGAN AVE STE 340
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-7444
Practice Address - Country:US
Practice Address - Phone:630-309-2044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-03
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180007705101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health