Provider Demographics
NPI:1487759700
Name:BAILLEAUX-RAGO, MICHELLE (PSYD LCPC)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:
Last Name:BAILLEAUX-RAGO
Suffix:
Gender:F
Credentials:PSYD LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3250 N ARLINGTON HTS RD
Mailing Address - Street 2:SUITE 112
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60067
Mailing Address - Country:US
Mailing Address - Phone:847-767-2120
Mailing Address - Fax:847-368-0764
Practice Address - Street 1:3250 N ARLINGTON HTS RD
Practice Address - Street 2:SUITE 112
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60067
Practice Address - Country:US
Practice Address - Phone:847-767-2120
Practice Address - Fax:847-368-0764
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist