Provider Demographics
NPI:1508999723
Name:SHATNEY, JOYCE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JOYCE
Middle Name:
Last Name:SHATNEY
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 1:6160 N CICERO AVE
Mailing Address - Street 2:SUITE 605
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646-4312
Mailing Address - Country:US
Mailing Address - Phone:847-796-5692
Mailing Address - Fax:847-965-6923
Practice Address - Street 1:6160 N CICERO AVE
Practice Address - Street 2:SUITE 605
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-4312
Practice Address - Country:US
Practice Address - Phone:847-796-5692
Practice Address - Fax:847-965-6923
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0022461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL81-0563573OtherPREVIOUS TAX ID NUMBER
IL81-0563573OtherPREVIOUS TAX ID NUMBER
IL1673512Medicare UPIN