Provider Demographics
NPI:1609497460
Name:SILVA, ENRIQUE II (LCPC)
Entity Type:Individual
Prefix:MR
First Name:ENRIQUE
Middle Name:
Last Name:SILVA
Suffix:II
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2633 S LOMBARD AVE
Mailing Address - Street 2:
Mailing Address - City:CICERO
Mailing Address - State:IL
Mailing Address - Zip Code:60804-3052
Mailing Address - Country:US
Mailing Address - Phone:312-351-2907
Mailing Address - Fax:
Practice Address - Street 1:1 UNIVERSITY PKWY STE 273
Practice Address - Street 2:
Practice Address - City:ROMEOVILLE
Practice Address - State:IL
Practice Address - Zip Code:60446-2200
Practice Address - Country:US
Practice Address - Phone:815-836-5455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-04
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.012822101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional