Healthcare Provider Details

I. General information

NPI: 1932541844
Provider Name (Legal Business Name): ABIGAIL DIAZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ABIGAIL SCHMINK LCSW

II. Dates (important events)

Enumeration Date: 07/19/2013
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 LAKEWOOD DR STE A
MORRIS IL
60450-3352
US

IV. Provider business mailing address

PO BOX 713260
CHICAGO IL
60677-0264
US

V. Phone/Fax

Practice location:
  • Phone: 815-942-6323
  • Fax: 779-210-5541
Mailing address:
  • Phone: 630-469-9200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number149-017939
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: