Healthcare Provider Details
I. General information
NPI: 1164228409
Provider Name (Legal Business Name): CHRISTINA L PINILLA LCSW PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/19/2025
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3037 N OKETO AVE
CHICAGO IL
60707-1203
US
IV. Provider business mailing address
3037 N OKETO AVE
CHICAGO IL
60707-1203
US
V. Phone/Fax
- Phone: 773-758-0082
- Fax:
- Phone: 773-758-0082
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041S0200X |
| Taxonomy | School Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHRISTINA
LYNN
PINILLA
Title or Position: OWNER/THERAPIST
Credential: LCSW
Phone: 773-758-0082