Provider Demographics
NPI:1265634521
Name:HORAN, DEBRA RENEE (MSW)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:RENEE
Last Name:HORAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10735 S CICERO AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-6210
Mailing Address - Country:US
Mailing Address - Phone:708-636-2211
Mailing Address - Fax:708-636-5552
Practice Address - Street 1:10735 S CICERO AVE STE 100
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-6210
Practice Address - Country:US
Practice Address - Phone:708-636-2211
Practice Address - Fax:708-636-5552
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0119341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical