Healthcare Provider Details

I. General information

NPI: 1730657834
Provider Name (Legal Business Name): DONALD R DAHLHEIMER LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2018
Last Update Date: 11/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 SALT CREEK LN STE 302
HINSDALE IL
60521-2903
US

IV. Provider business mailing address

8 SALT CREEK LN STE 302
HINSDALE IL
60521-2903
US

V. Phone/Fax

Practice location:
  • Phone: 331-221-6135
  • Fax:
Mailing address:
  • Phone: 331-221-6135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.008304
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: