Provider Demographics
NPI:1326261264
Name:COYNE, MEG-ANNE E (LCSW)
Entity Type:Individual
Prefix:
First Name:MEG-ANNE
Middle Name:E
Last Name:COYNE
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 1:3945 W DAKIN ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-3101
Mailing Address - Country:US
Mailing Address - Phone:773-583-7567
Mailing Address - Fax:
Practice Address - Street 1:20 N WACKER DR
Practice Address - Street 2:SUITE 1442
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60606-2806
Practice Address - Country:US
Practice Address - Phone:773-726-4600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0082531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL016535135OtherBLUE CROSS/BLUE SHIELD