Organization
LORI AITKEN, LCPC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI AITKEN LCPC (OWNER)
(847) 217-7836
Entity
Organization
Contact information
Practice address
1818 DEMPSTER ST, EVANSTON, IL 60202-1003
(847) 527-7421
Mailing address
621 HINMAN AVE, EVANSTON, IL 60202-3026
(847) 217-7836
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
180002521
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11753041
CAQH
IL
01
—
1617886
BLUE CROSS BLUE SHIELD
IL
Enumeration date
04/14/2011
Last updated
04/14/2011
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