Provider Demographics
NPI:1356501571
Name:PASTORE-HILLS, EMBER MARIE
Entity type:Individual
Prefix:DR
First Name:EMBER
Middle Name:MARIE
Last Name:PASTORE-HILLS
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:EMBER
Other - Middle Name:MARIE
Other - Last Name:PASTORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:7120 WINDSOR LAKE PARKWAY
Mailing Address - Street 2:
Mailing Address - City:LOVES PARK
Mailing Address - State:IL
Mailing Address - Zip Code:61111-3803
Mailing Address - Country:US
Mailing Address - Phone:815-877-9999
Mailing Address - Fax:815-877-2601
Practice Address - Street 1:7120 WINDSOR LAKE PKWY
Practice Address - Street 2:
Practice Address - City:LOVES PARK
Practice Address - State:IL
Practice Address - Zip Code:61111-3803
Practice Address - Country:US
Practice Address - Phone:815-877-9999
Practice Address - Fax:815-877-2601
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.002110101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional