Provider Demographics
NPI:1285498196
Name:SOL, MICHAELA CLAIRE
Entity type:Individual
Prefix:
First Name:MICHAELA
Middle Name:CLAIRE
Last Name:SOL
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 1:1232 CARYN TER
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-4607
Mailing Address - Country:US
Mailing Address - Phone:773-355-8019
Mailing Address - Fax:
Practice Address - Street 1:1232 CARYN TER
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-4607
Practice Address - Country:US
Practice Address - Phone:773-355-8019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL227021694225700000X
IL178003603101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist