Provider Demographics
NPI:1477884021
Name:GILLIES, NANCY LEE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:LEE
Last Name:GILLIES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 LAKE ST
Mailing Address - Street 2:UNIT 1F
Mailing Address - City:ROSELLE
Mailing Address - State:IL
Mailing Address - Zip Code:60172-3380
Mailing Address - Country:US
Mailing Address - Phone:630-346-1399
Mailing Address - Fax:
Practice Address - Street 1:1350 LAKE ST
Practice Address - Street 2:UNIT 1F
Practice Address - City:ROSELLE
Practice Address - State:IL
Practice Address - Zip Code:60172-3380
Practice Address - Country:US
Practice Address - Phone:630-346-1399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-21
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149-0068241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical