Provider Demographics
NPI:1326830357
Name:TOPAZ COUNSELING PLLC
Entity type:Organization
Organization Name:TOPAZ COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARGUERITE
Authorized Official - Middle Name:
Authorized Official - Last Name:WICKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-714-5401
Mailing Address - Street 1:1 E ERIE ST STE 525-2360
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2740
Mailing Address - Country:US
Mailing Address - Phone:312-714-5401
Mailing Address - Fax:
Practice Address - Street 1:1740 RIDGE AVE STE 201
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-5909
Practice Address - Country:US
Practice Address - Phone:312-714-5401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-17
Last Update Date:2025-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty