Provider Demographics
NPI:1407914484
Name:NEWKIRK, ALLEN W (MSW)
Entity Type:Individual
Prefix:MR
First Name:ALLEN
Middle Name:W
Last Name:NEWKIRK
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2625 BUTTERFIELD RD STE 103W
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-3418
Mailing Address - Country:US
Mailing Address - Phone:630-684-0499
Mailing Address - Fax:630-241-3989
Practice Address - Street 1:2625 BUTTERFIELD RD STE 103W
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-3418
Practice Address - Country:US
Practice Address - Phone:630-684-0499
Practice Address - Fax:630-241-3989
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical