Provider Demographics
NPI:1114097177
Name:LASCO, NANETTE (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:NANETTE
Middle Name:
Last Name:LASCO
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 E. WOODFIELD ROAD
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-5113
Mailing Address - Country:US
Mailing Address - Phone:815-356-5050
Mailing Address - Fax:815-356-5094
Practice Address - Street 1:390 E CONGRESS PKWY
Practice Address - Street 2:SUITE J
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-6202
Practice Address - Country:US
Practice Address - Phone:815-356-5050
Practice Address - Fax:815-356-5094
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1633897OtherBCBS IL GRP NUMBER
IL320078OtherVALUE OPTIONS GRP NUMBER
IL1633897OtherBCBS IL GRP NUMBER
IL320078OtherVALUE OPTIONS GRP NUMBER