Individual
ANA LILIA JAVIER-ETAPA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.C.P.C
Contact information
Practice address
10540 S WESTERN AVE, CHICAGO, IL 60643-2536
(708) 200-1306
(708) 634-2814
Mailing address
9519 S TRUMBULL AVE, EVERGREEN PARK, IL 60805-3058
(708) 200-1306
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180.007559
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1617631
BLUE CROSS BLUE SHIELD
IL
01
—
202591
MEDICARE
IL
Enumeration date
04/25/2007
Last updated
01/03/2023
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