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NPI Code Detail

MEDICARE: INDIVIDUAL AND FAMILY CONNECTION, LLC

MEDICARE: INDIVIDUAL AND FAMILY CONNECTION, LLC
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
1104100000XSocial WorkerIL
2261QM0855XAdolescent and Children Mental Health Clinic/Center
3101Y00000XCounselorIL

General Provider Information

NPI Number : 1871857615
Entity Type Code : Organization
Provider Name (Legal Business Name) : INDIVIDUAL AND FAMILY CONNECTION, LLC
Provider Business Mailing Address
First Line : 1806 N DAMEN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60647-5511
Country : US
Telephone Number : 773-270-0469
Fax Number :
Provider Business Practice Location Address
First Line : 1806 N DAMEN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60647-5511
Country : US
Telephone Number : 773-270-0469
Fax Number :
Authorized Official
Title or Position : THERAPIST, OWNER
Name : MS. JULIANNE C NEELY
Credential : MSW, LCSW
Telephone Number : 773-270-0469
Provider Enumeration Date : 06/26/2012
Last Update Date : 09/16/2025

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Directions to “INDIVIDUAL AND FAMILY CONNECTION, LLC ” Practice Location

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