Provider Demographics
NPI:1710245188
Name:CAMPILLO, MELANIE (LCPC, CCMHC)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:CAMPILLO
Suffix:
Gender:F
Credentials:LCPC, CCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 E DES MOINES ST
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-2004
Mailing Address - Country:US
Mailing Address - Phone:630-205-6347
Mailing Address - Fax:
Practice Address - Street 1:120 E OGDEN AVE
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3542
Practice Address - Country:US
Practice Address - Phone:630-325-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-24
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178007698101YP2500X
IL180.011147101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional