Provider Demographics
NPI:1407515919
Name:GONZALEZ, ANA LILY (LCPC)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:LILY
Last Name:GONZALEZ
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 1:7639 N GREENVIEW AVE APT 3W
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626-1291
Mailing Address - Country:US
Mailing Address - Phone:312-884-9047
Mailing Address - Fax:
Practice Address - Street 1:7639 N GREENVIEW AVE APT 3W
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60626-1291
Practice Address - Country:US
Practice Address - Phone:312-884-9047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-12
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.016294101YM0800X
IL180.015348101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health