Healthcare Provider Details

I. General information

NPI: 1326959321
Provider Name (Legal Business Name): LAUREN CHE ANDERSON JUSTICE LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 W IRVING PARK RD
CHICAGO IL
60613-2559
US

IV. Provider business mailing address

1700 W IRVING PARK RD
CHICAGO IL
60613-2559
US

V. Phone/Fax

Practice location:
  • Phone: 312-248-2882
  • Fax:
Mailing address:
  • Phone: 312-248-2882
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number150.130510
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: