Healthcare Provider Details

I. General information

NPI: 1154231850
Provider Name (Legal Business Name): LILLY WEHMAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 N SOUTHPORT AVE FL 2
CHICAGO IL
60657-4289
US

IV. Provider business mailing address

996 GROVE ST
WINNETKA IL
60093-1311
US

V. Phone/Fax

Practice location:
  • Phone: 773-799-8966
  • Fax:
Mailing address:
  • Phone: 847-867-1127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149031907
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: