Provider Demographics
NPI:1811586720
Name:TORTORICI, MEGHAN (LPC)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:TORTORICI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4003 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60513-1839
Mailing Address - Country:US
Mailing Address - Phone:708-328-1694
Mailing Address - Fax:
Practice Address - Street 1:120 E OGDEN AVE STE 125
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3767
Practice Address - Country:US
Practice Address - Phone:779-379-2311
Practice Address - Fax:779-220-0850
Is Sole Proprietor?:No
Enumeration Date:2021-01-14
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178015087101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional