Provider Demographics
NPI:1124534821
Name:GUERRERO, NICHOLAS M (MSW, LSW, CADC)
Entity Type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:M
Last Name:GUERRERO
Suffix:
Gender:M
Credentials:MSW, LSW, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6546 N TAHOMA AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646-2825
Mailing Address - Country:US
Mailing Address - Phone:773-951-4188
Mailing Address - Fax:
Practice Address - Street 1:1111 N WELLS ST STE 400
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610-7632
Practice Address - Country:US
Practice Address - Phone:312-573-8860
Practice Address - Fax:312-275-7922
Is Sole Proprietor?:No
Enumeration Date:2017-12-18
Last Update Date:2017-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL32995101YA0400X
IL150.101672104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)