Healthcare Provider Details

I. General information

NPI: 1073431227
Provider Name (Legal Business Name): PILAR AHUERMA LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 DEVONSHIRE DR STE B16-18
CHAMPAIGN IL
61820-7337
US

IV. Provider business mailing address

2506 POND ST
URBANA IL
61801-6935
US

V. Phone/Fax

Practice location:
  • Phone: 217-531-2360
  • Fax:
Mailing address:
  • Phone: 217-417-0062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number150.111670
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: