Provider Demographics
NPI:1427068014
Name:DULANEY, LILLIE (LCSW, CADC,SAP)
Entity type:Individual
Prefix:
First Name:LILLIE
Middle Name:
Last Name:DULANEY
Suffix:
Gender:F
Credentials:LCSW, CADC,SAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5100 N MARINE DR
Mailing Address - Street 2:18 B
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-3274
Mailing Address - Country:US
Mailing Address - Phone:773-728-7316
Mailing Address - Fax:773-728-8024
Practice Address - Street 1:55 E WASHINGTON ST
Practice Address - Street 2:2700
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-2103
Practice Address - Country:US
Practice Address - Phone:773-728-7316
Practice Address - Fax:773-728-8024
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL12280101YA0400X
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical