Provider Demographics
NPI:1275328320
Name:OCONNELL PSYCHOTHERAPY PLLC
Entity type:Organization
Organization Name:OCONNELL PSYCHOTHERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED AGENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIDGID
Authorized Official - Middle Name:
Authorized Official - Last Name:O'CONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:773-589-4198
Mailing Address - Street 1:7823 LOTUS AVE
Mailing Address - Street 2:
Mailing Address - City:MORTON GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60053-3626
Mailing Address - Country:US
Mailing Address - Phone:773-589-4198
Mailing Address - Fax:
Practice Address - Street 1:1608 W BELMONT AVE STE 204
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-3048
Practice Address - Country:US
Practice Address - Phone:773-589-4198
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-10
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty