Provider Demographics
NPI:1407547375
Name:OLVERA, KAREN (LSW)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:OLVERA
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3006 MAYFAIR AVE
Mailing Address - Street 2:
Mailing Address - City:WESTCHESTER
Mailing Address - State:IL
Mailing Address - Zip Code:60154-5013
Mailing Address - Country:US
Mailing Address - Phone:708-427-1008
Mailing Address - Fax:
Practice Address - Street 1:4614 MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-1212
Practice Address - Country:US
Practice Address - Phone:630-201-2856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-19
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150108428104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker