Provider Demographics
NPI:1720871510
Name:O'NEAL, DEREK LAMONE (LCSW)
Entity type:Individual
Prefix:
First Name:DEREK
Middle Name:LAMONE
Last Name:O'NEAL
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 1:5534 S WABASH AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60637-1071
Mailing Address - Country:US
Mailing Address - Phone:773-559-6887
Mailing Address - Fax:
Practice Address - Street 1:5534 S WABASH AVE APT 1
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-1071
Practice Address - Country:US
Practice Address - Phone:773-559-6887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-26
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0269471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical