MEDICARE: LAUREN CACCAMO WELLNESS, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1346192630
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAUREN CACCAMO WELLNESS, PLLC

Provider Business Mailing Address
First Line	:	717 N ELMHURST AVE
Second Line	:
City	:	MT PROSPECT
State	:	IL
Zip	:	60056-2017
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4611 N RAVENSWOOD AVE STE 105
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-7569
Country	:	US
Telephone Number	:	847-868-3504
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PSYCHOTHERAPIST
Name	:	LAUREN CACCAMO
Credential	:	LCSW
Telephone Number	:	847-899-5219

Provider Enumeration Date	:	02/10/2026
Last Update Date	:	02/10/2026

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