Provider Demographics
NPI:1508475229
Name:AKHTEEBO, VICTORIA
Entity Type:Individual
Prefix:MISS
First Name:VICTORIA
Middle Name:
Last Name:AKHTEEBO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7142 W NILES AVE
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-2122
Mailing Address - Country:US
Mailing Address - Phone:847-387-7116
Mailing Address - Fax:
Practice Address - Street 1:7142 W NILES AVE
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-2122
Practice Address - Country:US
Practice Address - Phone:847-387-7116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-28
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health