Provider Demographics
NPI:1275855140
Name:LEDUC, LOUISE (LCSW)
Entity Type:Individual
Prefix:
First Name:LOUISE
Middle Name:
Last Name:LEDUC
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 S HIGHLAND AVE
Mailing Address - Street 2:STE 300
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-4988
Mailing Address - Country:US
Mailing Address - Phone:630-792-1343
Mailing Address - Fax:
Practice Address - Street 1:1920 S HIGHLAND AVE
Practice Address - Street 2:STE 300
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-4988
Practice Address - Country:US
Practice Address - Phone:630-792-1343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-19
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490030011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical