Carly Jugo
Individual provider Active NPI Counselor · Riverwoods, IL
NPI 1245936350 · NPPES record last updated Dec 6, 2024
Key facts
- NPI
- 1245936350
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 2610 Lake Cook Rd Ste 133
Riverwoods, IL 60015-5710 - Phone
- (847) 219-5877
- NPI assigned
- Feb 1, 2023
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
2610 Lake Cook Rd Ste 133
Riverwoods, IL 60015-5710
Mailing address
2100 Walnut Cir
Northbrook, IL 60062-1248
Phone (847) 219-5877
Other providers in Riverwoods, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 6, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.