Provider Demographics
NPI:1427220995
Name:OLIVIERI, MAGGIE BERNADETTE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MAGGIE
Middle Name:BERNADETTE
Last Name:OLIVIERI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:MARGARET
Other - Middle Name:BERNADETTE
Other - Last Name:PALMER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:3166 N LINCOLN AVE
Mailing Address - Street 2:407
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-3133
Mailing Address - Country:US
Mailing Address - Phone:773-208-3202
Mailing Address - Fax:
Practice Address - Street 1:3500 N LAKE SHORE DR
Practice Address - Street 2:3D
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-1815
Practice Address - Country:US
Practice Address - Phone:773-208-3202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-25
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490129641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical