Provider Demographics
NPI:1215475900
Name:CHEN-MARTINEZ, WEI-CHIUNG (LCPC)
Entity type:Individual
Prefix:
First Name:WEI-CHIUNG
Middle Name:
Last Name:CHEN-MARTINEZ
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 1:6860 W OAKTON CT
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-3013
Mailing Address - Country:US
Mailing Address - Phone:773-417-6546
Mailing Address - Fax:
Practice Address - Street 1:6860 W OAKTON CT
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-3013
Practice Address - Country:US
Practice Address - Phone:773-417-6546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-02
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180011424101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional