Provider Demographics
NPI:1467670125
Name:DALIA, NIRALI D (LCPC)
Entity Type:Individual
Prefix:MS
First Name:NIRALI
Middle Name:D
Last Name:DALIA
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 MOUNT VERNON AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60045-2766
Mailing Address - Country:US
Mailing Address - Phone:312-259-5788
Mailing Address - Fax:
Practice Address - Street 1:101 W SUPERIOR ST
Practice Address - Street 2:UNIT # 803
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60654-7654
Practice Address - Country:US
Practice Address - Phone:312-259-5788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.007.217101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional