Provider Demographics
NPI:1154730901
Name:DIRILTEN, PATRICIA MICHELLE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:MICHELLE
Last Name:DIRILTEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:MICHELLE
Other - Last Name:DIRILTEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:2415 SKYLANE DR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-8531
Mailing Address - Country:US
Mailing Address - Phone:630-240-1647
Mailing Address - Fax:630-904-8124
Practice Address - Street 1:1333 BURR RIDGE PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:BURR RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60527-6423
Practice Address - Country:US
Practice Address - Phone:708-429-0353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-06
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490182411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical