Individual
DR. IVELISSE BURGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD, LPC, NCC
Contact information
Practice address
828 DAVIS ST STE 213, EVANSTON, IL 60201-4420
(312) 781-2850
(847) 972-6445
Mailing address
828 DAVIS ST STE 213, EVANSTON, IL 60201-4420
(312) 781-2850
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
178.013118
IL
103T00000X
Psychologist
Primary
071.010821
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/23/2016
Last updated
05/31/2023
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