Healthcare Provider Details

I. General information

NPI: 1295988897
Provider Name (Legal Business Name): NATALIE ADAIR LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2008
Last Update Date: 09/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15127 S 73RD AVE STE G
ORLAND PARK IL
60462-3425
US

IV. Provider business mailing address

1006 N SCOTT ST
WHEATON IL
60187-3864
US

V. Phone/Fax

Practice location:
  • Phone: 708-845-5500
  • Fax: 708-845-5505
Mailing address:
  • Phone: 773-504-9617
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149013302
License Number StateIL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier149013302
Identifier TypeOTHER
Identifier StateIL
Identifier IssuerLICENSE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: