Provider Demographics
NPI:1235681974
Name:ANNE TUMBORELLO AND ASSOCIATES
Entity Type:Organization
Organization Name:ANNE TUMBORELLO AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:TUMBORELLO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW CADC
Authorized Official - Phone:630-504-0705
Mailing Address - Street 1:2200 S MAIN ST STE 303
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-5366
Mailing Address - Country:US
Mailing Address - Phone:630-504-0705
Mailing Address - Fax:
Practice Address - Street 1:2200 S. MAIN STREET
Practice Address - Street 2:SUITE 303
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148
Practice Address - Country:US
Practice Address - Phone:630-504-0705
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-28
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0155271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty