Provider Demographics
NPI:1710312269
Name:MILAZZO, DONALD (LCPC)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:
Last Name:MILAZZO
Suffix:
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 1:476 ROCKHURST RD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-2439
Mailing Address - Country:US
Mailing Address - Phone:708-302-9113
Mailing Address - Fax:
Practice Address - Street 1:55 W 22ND ST STE 305
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-7048
Practice Address - Country:US
Practice Address - Phone:708-302-9113
Practice Address - Fax:630-283-7821
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-03
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178009038101YP2500X
IL180009697101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional