Provider Demographics
NPI:1972605228
Name:BORGMAN, STEPHEN (LCPC)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:BORGMAN
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18-2 E DUNDEE RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-5270
Mailing Address - Country:US
Mailing Address - Phone:847-737-5277
Mailing Address - Fax:
Practice Address - Street 1:18-2 E DUNDEE RD
Practice Address - Street 2:SUITE 140
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-5270
Practice Address - Country:US
Practice Address - Phone:847-737-5277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-003883101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL320078OtherVALUE OPTIONS GRP #
IL207844Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER
IL344426OtherMHN PROVIDER NUMBER
IL1633897OtherBCBS GRP PROVIDER #