Provider Demographics
NPI:1487653788
Name:CHUTIS, LAURIEANN (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:LAURIEANN
Middle Name:
Last Name:CHUTIS
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 1:5550 S SHORE DR
Mailing Address - Street 2:SUITE 1107
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60637-5034
Mailing Address - Country:US
Mailing Address - Phone:773-753-4638
Mailing Address - Fax:
Practice Address - Street 1:5550 S SHORE DR
Practice Address - Street 2:SUITE 1107
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-5034
Practice Address - Country:US
Practice Address - Phone:773-753-4638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-19
Last Update Date:2017-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490006851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical