Provider Demographics
NPI:1235284449
Name:LANZL, ERIC L (LCSW)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:L
Last Name:LANZL
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 1:6715 N HIAWATHA AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646-1417
Mailing Address - Country:US
Mailing Address - Phone:773-315-6250
Mailing Address - Fax:
Practice Address - Street 1:6160 N CICERO AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-4312
Practice Address - Country:US
Practice Address - Phone:773-315-6250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490005161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical