Provider Demographics
NPI:1487679460
Name:ERIC H LAMB LCSW PC
Entity Type:Organization
Organization Name:ERIC H LAMB LCSW PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:H
Authorized Official - Last Name:LAMB
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:630-513-5576
Mailing Address - Street 1:1 ILLINOIS ST
Mailing Address - Street 2:SUITE 215
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-2847
Mailing Address - Country:US
Mailing Address - Phone:630-513-5576
Mailing Address - Fax:847-985-4534
Practice Address - Street 1:1 ILLINOIS ST
Practice Address - Street 2:SUITE 215
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-2847
Practice Address - Country:US
Practice Address - Phone:630-513-5576
Practice Address - Fax:847-985-4534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL04508317OtherBCBS
IL210118Medicare PIN
IL04508317OtherBCBS