Provider Demographics
NPI:1477589802
Name:DEVETT, F. FREDERICK (LCSW)
Entity Type:Individual
Prefix:MR
First Name:F.
Middle Name:FREDERICK
Last Name:DEVETT
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 BUTTERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60502-8609
Mailing Address - Country:US
Mailing Address - Phone:630-897-7215
Mailing Address - Fax:
Practice Address - Street 1:850 BUTTERFIELD RD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60502-8609
Practice Address - Country:US
Practice Address - Phone:630-897-7221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11751041C0700X
WI17106H00000X
IL166000732106H00000X
IL1490128711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39228900Medicaid
WIR63603Medicare UPIN
082691003Medicare ID - Type Unspecified