1184865271 NPI number — MRS. DARLENE F CONRAD MSW, LCSW

Table of content: MRS. DARLENE F CONRAD MSW, LCSW (NPI 1184865271)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184865271 NPI number — MRS. DARLENE F CONRAD MSW, LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CONRAD
Provider First Name:
DARLENE
Provider Middle Name:
F
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MSW, LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1184865271
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/06/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
21635 W HILANDALE CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KILDEER
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60047-8842
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-507-0799
Provider Business Mailing Address Fax Number:
847-847-1562

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1217 MCHENRY RD
Provider Second Line Business Practice Location Address:
SUITE 237
Provider Business Practice Location Address City Name:
BUFFALO GROVE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60089-1379
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-507-0799
Provider Business Practice Location Address Fax Number:
847-847-1562
Provider Enumeration Date:
03/18/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  149-009197 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com