Provider Demographics
NPI:1518071166
Name:DUBOIS, NATALIE E
Entity Type:Individual
Prefix:MS
First Name:NATALIE
Middle Name:E
Last Name:DUBOIS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:NATALIE
Other - Middle Name:E
Other - Last Name:GREBEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:9444 LAWNDALE AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60203-1307
Mailing Address - Country:US
Mailing Address - Phone:773-680-5620
Mailing Address - Fax:
Practice Address - Street 1:636 CHURCH ST
Practice Address - Street 2:SUITE 615
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-4508
Practice Address - Country:US
Practice Address - Phone:773-680-5620
Practice Address - Fax:847-329-0094
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490021021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical