Provider Demographics
NPI:1407444102
Name:DUGAS, ERIN
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:DUGAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 W MELROSE ST UNIT 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-7233
Mailing Address - Country:US
Mailing Address - Phone:225-715-5747
Mailing Address - Fax:
Practice Address - Street 1:4700 N RAVENSWOOD AVE STE C
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-4408
Practice Address - Country:US
Practice Address - Phone:773-754-7441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-07
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490228811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical