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General NPI Number Information
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NPI Number | 1609007277
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Entity Type | Individual
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Provider Name | DOLORES LARKIN LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/30/2009
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Last Update Date | 03/15/2016
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Provider Practice Location Address
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Address Line | 401 SOUTH LASALLE ST 801 - CHICAGO PERSONAL GROWTH INSTITUTE
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City | CHICAGO
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State | IL
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Zip | 60605-1057
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Country | US
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Telephone | 708-927-0990
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Fax | 773-826-1835
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Provider Business Mailing Address
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Address Line | 1141 HIGHLAND AVE
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City | OAK PARK
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State | IL
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Zip | 60304-2209
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Country | US
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Telephone | 708-927-0990
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 149009735
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License Number State | IL
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