Provider Demographics
NPI:1508307026
Name:BURNS, MARGARET (LCP)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:BURNS
Suffix:
Gender:F
Credentials:LCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:437 SHERWOOD RD APT 1
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60526-2103
Mailing Address - Country:US
Mailing Address - Phone:708-651-1109
Mailing Address - Fax:
Practice Address - Street 1:437 SHERWOOD RD APT 1
Practice Address - Street 2:
Practice Address - City:LA GRANGE PARK
Practice Address - State:IL
Practice Address - Zip Code:60526-2103
Practice Address - Country:US
Practice Address - Phone:708-651-1109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-16
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
IL178012926101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional