Healthcare Provider Details

I. General information

NPI: 1487796363
Provider Name (Legal Business Name): MEGHAN CHRISTINE LLANES LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 05/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901A CENTRAL ST. SUITE 6
EVANSTON IL
60201
US

IV. Provider business mailing address

2300 COLFAX ST
EVANSTON IL
60201-2102
US

V. Phone/Fax

Practice location:
  • Phone: 312-927-1191
  • Fax: 866-284-8499
Mailing address:
  • Phone: 312-927-1191
  • Fax: 866-284-8499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149-010608
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: