Healthcare Provider Details

I. General information

NPI: 1336292358
Provider Name (Legal Business Name): CINDY TAKIGUCHI FUERST LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CINDY TAKIGUCHI

II. Dates (important events)

Enumeration Date: 01/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 W ROOSEVELT RD STE B1
WHEATON IL
60187-5087
US

IV. Provider business mailing address

1067 ELA RD
INVERNESS IL
60067-4262
US

V. Phone/Fax

Practice location:
  • Phone: 630-462-3999
  • Fax: 630-462-0911
Mailing address:
  • Phone: 630-462-3999
  • Fax: 630-462-0911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: