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Costa Provis, L.C.P.C

NPI 1679767826 · on the registry since 2007 · sole proprietor

Practice

Address: 444 N Michigan Ave
Chicago, IL 60611
Phone: (847) 529-8607
Organisation at this address: Soulful Rt
Healthyworks
Elt4 Nc, P.C.
Retrofit, Inc.
Zest Health, Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 24

Registry record

Primary taxonomy: Professional Counselor
101YP2500X
Licence states on file: IL
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2007-08-30

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois