Provider Demographics
NPI:1689732653
Name:VANDERCOOK, VIOLA LEVEILLE (MS ED, LPCP, NCC)
Entity Type:Individual
Prefix:MRS
First Name:VIOLA
Middle Name:LEVEILLE
Last Name:VANDERCOOK
Suffix:
Gender:F
Credentials:MS ED, LPCP, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 S SCHMALE RD
Mailing Address - Street 2:SUITE 223
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-2791
Mailing Address - Country:US
Mailing Address - Phone:630-640-2622
Mailing Address - Fax:630-668-4308
Practice Address - Street 1:380 S SCHMALE RD
Practice Address - Street 2:SUITE 223
Practice Address - City:CAROL STREAM
Practice Address - State:IL
Practice Address - Zip Code:60188-2791
Practice Address - Country:US
Practice Address - Phone:630-640-2622
Practice Address - Fax:630-668-4308
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-003665101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL52-2453020OtherTAX ID NUMBER