Provider Demographics
NPI:1386725711
Name:CHO, IRENE (LCPC, LMFT)
Entity type:Individual
Prefix:MRS
First Name:IRENE
Middle Name:
Last Name:CHO
Suffix:
Gender:F
Credentials:LCPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 W ROOSEVELT RD
Mailing Address - Street 2:SUITE B-1
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-5087
Mailing Address - Country:US
Mailing Address - Phone:630-462-3999
Mailing Address - Fax:630-462-0911
Practice Address - Street 1:4300 COMMERCE CT
Practice Address - Street 2:SUITE 300-8
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-3709
Practice Address - Country:US
Practice Address - Phone:630-344-9390
Practice Address - Fax:630-984-4427
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-002325101YP2500X
IL166-000527106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist