Provider Demographics
NPI:1083169981
Name:DIAZ, LINZI SWISHER (LCSW)
Entity Type:Individual
Prefix:
First Name:LINZI
Middle Name:SWISHER
Last Name:DIAZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2726 W CORTEZ ST APT 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-6131
Mailing Address - Country:US
Mailing Address - Phone:573-795-6132
Mailing Address - Fax:
Practice Address - Street 1:30 N MICHIGAN AVE STE 1217
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-3732
Practice Address - Country:US
Practice Address - Phone:573-795-6132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-20
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0181691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical