Provider Demographics
NPI:1275972663
Name:LUGLIO, CANDICE (PHD)
Entity Type:Individual
Prefix:DR
First Name:CANDICE
Middle Name:
Last Name:LUGLIO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3330 OLD GLENVIEW RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091-2963
Mailing Address - Country:US
Mailing Address - Phone:773-680-1543
Mailing Address - Fax:
Practice Address - Street 1:3330 OLD GLENVIEW RD
Practice Address - Street 2:SUITE 1
Practice Address - City:WILMETTE
Practice Address - State:IL
Practice Address - Zip Code:60091-2963
Practice Address - Country:US
Practice Address - Phone:773-680-1543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-18
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071006729103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical