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Contact Information

SERGIO AYALA, M.DIV., M.S., LMHC
7601 S KOSTNER AVE
CHICAGO, IL60652-1126
 Phone: 630-936-1839
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Mental Health

101YM0800X
 

Addiction (Substance Use Disorder)

101YA0400X
 

Professional

101YP2500X
Indicates primary specialty

NPI Profile & details for SERGIO AYALA · (Male)

NPI Number 1619535002
Status Active
Credentials M.DIV., M.S., LMHC
Entity Individual
Enumeration date 05/31/2019
Last updated 05/31/2019 - About 7 years ago
Sole proprietor 1 Yes
Identifiers
  • IA License # 094835
  • IL License # 178.010795
  • IL License # 33810
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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