Healthcare Provider Details

I. General information

NPI: 1982296265
Provider Name (Legal Business Name): ERIN ELIZABETH MATTUCCI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2021
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9501 W 144TH PL STE 304
ORLAND PARK IL
60462-2564
US

IV. Provider business mailing address

9501 W 144TH PL STE 304
ORLAND PARK IL
60462-2564
US

V. Phone/Fax

Practice location:
  • Phone: 708-628-8000
  • Fax:
Mailing address:
  • Phone: 708-628-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.025491
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: