Healthcare Provider Details

I. General information

NPI: 1982510632
Provider Name (Legal Business Name): ADDIE OGARA THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1086 CRESCENT LN
WINNETKA IL
60093-1501
US

IV. Provider business mailing address

1086 CRESCENT LN
WINNETKA IL
60093-1501
US

V. Phone/Fax

Practice location:
  • Phone: 224-688-4848
  • Fax:
Mailing address:
  • Phone: 224-688-4848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MARY NELSON
Title or Position: OWNER
Credential: LCSW
Phone: 224-688-4848