Provider Demographics
NPI:1205318243
Name:ISOM, SHEREE (LCPC)
Entity type:Individual
Prefix:
First Name:SHEREE
Middle Name:
Last Name:ISOM
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15303 S 94TH AVE STE 250
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-3825
Mailing Address - Country:US
Mailing Address - Phone:833-591-7818
Mailing Address - Fax:
Practice Address - Street 1:15303 S 94TH AVE STE 250
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-3825
Practice Address - Country:US
Practice Address - Phone:833-591-7818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-06
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.017228101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional