Provider Demographics
NPI:1740142546
Name:ESTRADA, MARIA (BSW)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:ESTRADA
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:MAR
Other - Middle Name:
Other - Last Name:ESTRADA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BSW
Mailing Address - Street 1:1111 W LAKE COOK RD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-1926
Mailing Address - Country:US
Mailing Address - Phone:847-353-1758
Mailing Address - Fax:
Practice Address - Street 1:1111 W LAKE COOK RD
Practice Address - Street 2:
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-1926
Practice Address - Country:US
Practice Address - Phone:847-353-1758
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-12-01
Last Update Date:2025-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor