Provider Demographics
NPI:1043827116
Name:ALTOBELLI, MICHAEL ANTHONY (LCPC, CCMHC, NCC)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:ANTHONY
Last Name:ALTOBELLI
Suffix:
Gender:
Credentials:LCPC, CCMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 ARBORDALE LN
Mailing Address - Street 2:
Mailing Address - City:ALGONQUIN
Mailing Address - State:IL
Mailing Address - Zip Code:60102-3263
Mailing Address - Country:US
Mailing Address - Phone:630-930-2267
Mailing Address - Fax:
Practice Address - Street 1:2500 W HIGGINS RD STE 105
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-2040
Practice Address - Country:US
Practice Address - Phone:888-870-1775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-23
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.016231101YM0800X, 102L00000X, 101YP2500X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
No101Y00000XBehavioral Health & Social Service ProvidersCounselor