Organization
IDA LILLIE PSYCHOTHERAPY AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHLA DAVIS LCPC (OWNER)
(618) 207-5873
Entity
Organization
Contact information
Practice address
1300 W BELMONT AVE # 400B, CHICAGO, IL 60657-3200
(618) 207-5873
Mailing address
1300 W BELMONT AVE # 400B, CHICAGO, IL 60657-3200
(618) 207-5873
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
06/10/2022
Last updated
02/23/2023
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