Healthcare Provider Details

I. General information

NPI: 1699691014
Provider Name (Legal Business Name): CARA LIACE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1110 W LAKE COOK RD STE 240
BUFFALO GROVE IL
60089-1968
US

IV. Provider business mailing address

1110 W LAKE COOK RD STE 240
BUFFALO GROVE IL
60089-1968
US

V. Phone/Fax

Practice location:
  • Phone: 847-636-1698
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149020766
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: