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General NPI Number Information
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NPI Number | 1801564968
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Entity Type | Individual
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Provider Name | LILY CALDERO
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Gender | Female
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Dates
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Enumeration Date | 09/02/2021
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Last Update Date | 09/02/2021
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Provider Practice Location Address
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Address Line | 10001 GRAND AVE STE 1
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City | FRANKLIN PARK
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State | IL
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Zip | 60131-2564
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Country | US
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Telephone | 847-451-0330
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Fax |
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Provider Business Mailing Address
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Address Line | 3732 N CENTRAL PARK AVE
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City | CHICAGO
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State | IL
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Zip | 60618-4109
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Country | US
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Telephone | 773-621-8553
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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 |
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License Number State |
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