Provider Demographics
NPI:1235557646
Name:NTIM, NANCY SUE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:SUE
Last Name:NTIM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:NANCY
Other - Middle Name:SUE
Other - Last Name:KUHLMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:2007 ELIM AVE # B
Mailing Address - Street 2:
Mailing Address - City:ZION
Mailing Address - State:IL
Mailing Address - Zip Code:60099-1827
Mailing Address - Country:US
Mailing Address - Phone:224-656-9037
Mailing Address - Fax:
Practice Address - Street 1:2007 ELIM AVE # B
Practice Address - Street 2:
Practice Address - City:ZION
Practice Address - State:IL
Practice Address - Zip Code:60099-1827
Practice Address - Country:US
Practice Address - Phone:224-656-9037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-02
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149-0054031041C0700X
WI8085-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical