Provider Demographics
NPI:1255966537
Name:BADGER, CHRISTINE E (LCPC)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:E
Last Name:BADGER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4001 N WOLCOTT AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-2411
Mailing Address - Country:US
Mailing Address - Phone:773-789-9775
Mailing Address - Fax:
Practice Address - Street 1:4001 N WOLCOTT AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-2411
Practice Address - Country:US
Practice Address - Phone:773-789-9775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-07
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.015768101YP2500X
IL180.015156101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional