Provider Demographics
NPI:1194845180
Name:EIPERS, AMIE C (LCSW)
Entity type:Individual
Prefix:MS
First Name:AMIE
Middle Name:C
Last Name:EIPERS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 OCONTO CT
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-9522
Mailing Address - Country:US
Mailing Address - Phone:630-379-4294
Mailing Address - Fax:630-995-3714
Practice Address - Street 1:29 S WEBSTER ST STE 395
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-3101
Practice Address - Country:US
Practice Address - Phone:630-379-4294
Practice Address - Fax:630-995-3714
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-31
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490111091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1184775413OtherORGANIZATIONAL NPI
IL1194845180Medicaid