Healthcare Provider Details

I. General information

NPI: 1720592975
Provider Name (Legal Business Name): ALLISON POLZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALLISON GRENDZINSKI LCSW

II. Dates (important events)

Enumeration Date: 11/27/2017
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3251 COMMERCE DR STE C
DEKALB IL
60115-7908
US

IV. Provider business mailing address

3251 COMMERCE DR STE C
DEKALB IL
60115-7908
US

V. Phone/Fax

Practice location:
  • Phone: 815-345-3086
  • Fax:
Mailing address:
  • Phone: 815-345-3086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149022128
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number150.102716
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: