Provider Demographics
NPI:1841646999
Name:PAGONE, EMILY (LCPC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:PAGONE
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 1:211 W CHICAGO AVE STE 119
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3355
Mailing Address - Country:US
Mailing Address - Phone:630-207-2482
Mailing Address - Fax:630-708-7573
Practice Address - Street 1:211 W CHICAGO AVE STE 119
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3355
Practice Address - Country:US
Practice Address - Phone:630-796-0884
Practice Address - Fax:630-708-7573
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-08
Last Update Date:2023-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180012775101YM0800X, 101YP2500X
IL180.012775101YP2500X
IL178011299101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL180012775OtherIDFPR
IL248002861OtherIDFPR
IL1396357737OtherNPI 2