Provider Demographics
NPI:1477812097
Name:MCHUGH-CHALJUB, MARY ANNE (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:MARY ANNE
Middle Name:
Last Name:MCHUGH-CHALJUB
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:MS
Other - First Name:MOLLY
Other - Middle Name:
Other - Last Name:MCHUGH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2142 N 77TH CT
Mailing Address - Street 2:
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60707-3016
Mailing Address - Country:US
Mailing Address - Phone:708-306-7030
Mailing Address - Fax:
Practice Address - Street 1:2114 DEERPATH RD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-7943
Practice Address - Country:US
Practice Address - Phone:630-907-1735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-16
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.007319101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health