Healthcare Provider Details

I. General information

NPI: 1972085447
Provider Name (Legal Business Name): ALEXYS MARIE OPEL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2018
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 N WESTMORELAND RD
LAKE FOREST IL
60045-1658
US

IV. Provider business mailing address

1000 N WESTMORELAND RD
LAKE FOREST IL
60045-1658
US

V. Phone/Fax

Practice location:
  • Phone: 847-535-7658
  • Fax: 847-535-7150
Mailing address:
  • Phone: 847-535-7658
  • Fax: 847-535-7150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149028984
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: