Provider Demographics
NPI:1366676140
Name:MARILEE FELDMAN, MS, LCPC, CADC, LLC
Entity Type:Organization
Organization Name:MARILEE FELDMAN, MS, LCPC, CADC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARILEE
Authorized Official - Middle Name:
Authorized Official - Last Name:FELDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LCPC, CADC
Authorized Official - Phone:630-269-2886
Mailing Address - Street 1:545 PLAINFIELD RD STE E
Mailing Address - Street 2:
Mailing Address - City:WILLOWBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60527-7601
Mailing Address - Country:US
Mailing Address - Phone:630-269-2886
Mailing Address - Fax:
Practice Address - Street 1:545 PLAINFIELD RD STE E
Practice Address - Street 2:
Practice Address - City:WILLOWBROOK
Practice Address - State:IL
Practice Address - Zip Code:60527-7601
Practice Address - Country:US
Practice Address - Phone:630-269-2886
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-08
Last Update Date:2009-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-006809101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02233589OtherBLUE CROSS AND BLUE SHIELD