Healthcare Provider Details

I. General information

NPI: 1205706777
Provider Name (Legal Business Name): SUZANNE CAULFIELD CECELIA CAULFIELD LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2025
Last Update Date: 11/10/2025
Certification Date: 11/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 RIDGE AVE
EVANSTON IL
60201-1700
US

IV. Provider business mailing address

5922 N FAIRFIELD AVE
CHICAGO IL
60659-3908
US

V. Phone/Fax

Practice location:
  • Phone: 847-570-2556
  • Fax:
Mailing address:
  • Phone: 847-570-2556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number150.012926
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: