Provider Demographics
NPI:1144399775
Name:FRANCIS, MICHAEL J (LCSW)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:J
Last Name:FRANCIS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 E PROSPECT AVE
Mailing Address - Street 2:SUITE 215
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-3366
Mailing Address - Country:US
Mailing Address - Phone:847-334-3745
Mailing Address - Fax:
Practice Address - Street 1:401 E PROSPECT AVE
Practice Address - Street 2:SUITE 215
Practice Address - City:MOUNT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056
Practice Address - Country:US
Practice Address - Phone:847-334-3745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2018-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
IL1490000411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
1671635OtherBLUE SHIELD
1671635OtherBLUE SHIELD