Provider Demographics
NPI:1093120792
Name:AGUILAR, LORENA (LCSW)
Entity Type:Individual
Prefix:
First Name:LORENA
Middle Name:
Last Name:AGUILAR
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 1:3600 W FULLERTON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-2319
Mailing Address - Country:US
Mailing Address - Phone:773-782-2800
Mailing Address - Fax:773-782-5042
Practice Address - Street 1:2246 W LAWRENCE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-1929
Practice Address - Country:US
Practice Address - Phone:773-316-9432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-22
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490167641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical