Healthcare Provider Details

I. General information

NPI: 1275584153
Provider Name (Legal Business Name): DEBBIE K CHIRIKOS MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 09/10/2008
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

PO BOX 188
BARRINGTON IL
60011-0188
US

V. Phone/Fax

Practice location:
  • Phone: 847-770-3484
  • Fax: 847-658-3446
Mailing address:
  • Phone: 847-770-3484
  • Fax: 847-658-3446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.011586
License Number StateIL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: