Provider Demographics
NPI:1104921683
Name:MARY BETH MCLAUGHLIN,LTD
Entity type:Organization
Organization Name:MARY BETH MCLAUGHLIN,LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLAUGHLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LCSW
Authorized Official - Phone:630-305-0464
Mailing Address - Street 1:1300 IROQUOIS AVE STE 145
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-1389
Mailing Address - Country:US
Mailing Address - Phone:630-305-0464
Mailing Address - Fax:630-305-0211
Practice Address - Street 1:1300 IROQUOIS AVE STE 145
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-1389
Practice Address - Country:US
Practice Address - Phone:630-305-0464
Practice Address - Fax:630-305-0211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149-0028151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02271467OtherBCBS PROVIDER #
IL624370Medicare PIN