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General NPI Number Information
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NPI Number | 1871857615
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Entity Type | Organization
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Legal Business Name | INDIVIDUAL AND FAMILY CONNECTION, LLC
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Dates
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Enumeration Date | 06/26/2012
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 1806 N DAMEN AVE
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City | CHICAGO
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State | IL
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Zip | 60647-5511
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Country | US
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Telephone | 773-270-0469
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Fax |
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Provider Business Mailing Address
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Address Line | 1806 N DAMEN AVE
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City | CHICAGO
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State | IL
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Zip | 60647-5511
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Country | US
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Telephone | 773-270-0469
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Fax |
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Authorized Official
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Title or Position | THERAPIST, OWNER
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Name | MS. JULIANNE C NEELY
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Credential | MSW, LCSW
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Telephone | 773-270-0469
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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 | IL
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State | IL
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