Provider Demographics
NPI:1437331394
Name:FROY, ILYSE HOPE (MA, LCPC)
Entity Type:Individual
Prefix:MS
First Name:ILYSE
Middle Name:HOPE
Last Name:FROY
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 1:3251 N DAMEN AVE
Mailing Address - Street 2:SUITE 2N
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-6787
Mailing Address - Country:US
Mailing Address - Phone:773-458-4849
Mailing Address - Fax:
Practice Address - Street 1:2526 N LINCOLN AVE
Practice Address - Street 2:SUITE 218
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-2353
Practice Address - Country:US
Practice Address - Phone:773-458-4849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-03
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional