Healthcare Provider Details
I. General information
NPI: 1477529865
Provider Name (Legal Business Name): CINDY R HITCHCOCK MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/24/2006
Last Update Date: 10/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2500 W. HIGGINS ROAD SUITE 1279
HOFFMAN ESTATES IL
60169-2051
US
IV. Provider business mailing address
2500 W. HIGGINS ROAD SUITE 1279
HOFFMAN ESTATES IL
60169-2051
US
V. Phone/Fax
- Phone: 847-373-5700
- Fax: 847-884-7441
- Phone: 847-373-5700
- Fax: 847-884-7441
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | 149-008403 |
| License Number State | IL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 149008403 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: