Provider Demographics
NPI:1215081187
Name:MAIGLER, DANIEL J (LCSW)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:J
Last Name:MAIGLER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1222 S PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-5343
Mailing Address - Country:US
Mailing Address - Phone:847-477-8792
Mailing Address - Fax:
Practice Address - Street 1:711 DEVON AVE
Practice Address - Street 2:204
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-4713
Practice Address - Country:US
Practice Address - Phone:847-477-8792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490116081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical