Healthcare Provider Details

I. General information

NPI: 1972993988
Provider Name (Legal Business Name): NANCY A ESCHBACH LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/28/2015
Last Update Date: 12/05/2022
Certification Date: 12/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1585 ELLINWOOD AVE SUITE 106
DES PLAINES IL
60016-4510
US

IV. Provider business mailing address

844 AZURE CT
COROLLA NC
27927-9699
US

V. Phone/Fax

Practice location:
  • Phone: 847-877-3970
  • Fax:
Mailing address:
  • Phone: 847-877-3970
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149004925
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: