Provider Demographics
NPI:1962078154
Name:IZZO, CAPRI DANIELE (LCSW)
Entity type:Individual
Prefix:
First Name:CAPRI
Middle Name:DANIELE
Last Name:IZZO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CARLO
Other - Middle Name:DANIELE
Other - Last Name:IZZO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:155 N MICHIGAN AVE STE 450
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-7939
Mailing Address - Country:US
Mailing Address - Phone:872-395-8091
Mailing Address - Fax:
Practice Address - Street 1:155 N MICHIGAN AVE STE 450
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-7939
Practice Address - Country:US
Practice Address - Phone:872-395-8091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-28
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.104924104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker