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NPI 1639619406

NPI 1639619406 : TRIKINA BANKS LCSW : GURNEE, IL

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General NPI Number Information
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    NPI Number           |    1639619406
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    Entity Type          |    Individual 
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    Provider Name        |    TRIKINA BANKS LCSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/27/2017
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    Last Update Date     |    06/25/2024
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Provider Practice Location Address
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    Address Line         |    7900 ROLLINS RD 
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    City                 |    GURNEE
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    State                |    IL
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    Zip                  |    60031-1512
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    Country              |    US
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    Telephone            |    847-425-6400
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    Fax                  |    847-425-6408
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Provider Business Mailing Address
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    Address Line         |    7900 ROLLINS RD 
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    City                 |    GURNEE
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    State                |    IL
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    Zip                  |    60031-1512
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    Country              |    US
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    Telephone            |    847-425-6400
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    Fax                  |    847-425-6408
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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        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    149018062
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    License Number State |    IL
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