Healthcare Provider Details
I. General information
NPI: 1073782959
Provider Name (Legal Business Name): WORK WITH FAMILIES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/26/2008
Last Update Date: 02/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10075 N RIVER RD
ALGONQUIN IL
60102-9685
US
IV. Provider business mailing address
10075 N RIVER RD
ALGONQUIN IL
60102-9685
US
V. Phone/Fax
- Phone: 847-770-3484
- Fax: 847-658-3446
- Phone: 847-770-3484
- Fax: 847-658-3446
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | IL |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name: MS.
DEBBIE
CHIRIKOS
Title or Position: THERAPIST
Credential: LCSW
Phone: 847-770-3484