Provider Demographics
NPI:1518079599
Name:MCLEAN, JULIE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:
Last Name:MCLEAN
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 1:1212 TENNYSON LN
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-0330
Mailing Address - Country:US
Mailing Address - Phone:630-305-8029
Mailing Address - Fax:
Practice Address - Street 1:132 E 79TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60619-2302
Practice Address - Country:US
Practice Address - Phone:773-487-0515
Practice Address - Fax:773-487-0525
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK16306Medicare ID - Type Unspecified