Provider Demographics
NPI:1285820662
Name:LILLY, APRIL ANN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:APRIL
Middle Name:ANN
Last Name:LILLY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:APRIL
Other - Middle Name:ANN
Other - Last Name:TALLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2609 W CORTLAND ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-4210
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2858 W DIVERSEY AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-1871
Practice Address - Country:US
Practice Address - Phone:773-998-2119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-19
Last Update Date:2016-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490172021041C0700X
CAASW 324941041C0700X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical