Provider Demographics
NPI:1194127662
Name:FORESIGHT AHORA CLINCAL & CONSULTING SERVICES
Entity type:Organization
Organization Name:FORESIGHT AHORA CLINCAL & CONSULTING SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CECILIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:1630-368-0121
Mailing Address - Street 1:1301 W 22ND ST
Mailing Address - Street 2:SUITE 310
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-2006
Mailing Address - Country:US
Mailing Address - Phone:630-368-0122
Mailing Address - Fax:
Practice Address - Street 1:1301 W 22ND ST
Practice Address - Street 2:SUITE 310
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-2006
Practice Address - Country:US
Practice Address - Phone:630-368-0122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-16
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.010278101Y00000X
IL180.004751101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty