Provider Demographics
NPI:1235945718
Name:EICHER, EMILY CLAIRE
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:CLAIRE
Last Name:EICHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3445 W PARKER AVE # 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-1224
Mailing Address - Country:US
Mailing Address - Phone:248-766-4298
Mailing Address - Fax:
Practice Address - Street 1:333 SKOKIE BLVD STE 108
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-1623
Practice Address - Country:US
Practice Address - Phone:847-550-6393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.019920101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health