Provider Demographics
NPI:1659026086
Name:COUMBE-LILLEY, JOHN E (PHD, LPC, ALMFT)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:E
Last Name:COUMBE-LILLEY
Suffix:
Gender:M
Credentials:PHD, LPC, ALMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3631 N HALSTED ST
Mailing Address - Street 2:APT 311
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-4579
Mailing Address - Country:US
Mailing Address - Phone:312-320-3501
Mailing Address - Fax:
Practice Address - Street 1:132 W LAKE ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-1020
Practice Address - Country:US
Practice Address - Phone:312-620-0714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-14
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.017770101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional