Provider Demographics
NPI:1851721039
Name:VILLARREAL, MICHAEL (LCPC)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:VILLARREAL
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 1:737 N MICHIGAN AVE STE 2130
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-6747
Mailing Address - Country:US
Mailing Address - Phone:773-991-5762
Mailing Address - Fax:847-991-7284
Practice Address - Street 1:737 N MICHIGAN AVE STE 2130
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-6747
Practice Address - Country:US
Practice Address - Phone:773-789-9775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-25
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180010064101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL101YP2500XOtherCMS.GOV