Provider Demographics
NPI:1104077189
Name:CLUTS, ERIN JOAN (MSW, LCSW)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:JOAN
Last Name:CLUTS
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:MISS
Other - First Name:ERIN
Other - Middle Name:JOAN
Other - Last Name:QUILLMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:616 W 5TH AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-2914
Mailing Address - Country:US
Mailing Address - Phone:630-799-0100
Mailing Address - Fax:630-799-0180
Practice Address - Street 1:103 N 11TH AVE
Practice Address - Street 2:SUITE 109
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-2289
Practice Address - Country:US
Practice Address - Phone:630-799-0100
Practice Address - Fax:630-799-0180
Is Sole Proprietor?:No
Enumeration Date:2008-10-08
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490086851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL917190001Medicare PIN