Provider Demographics
NPI:1518909589
Name:COLLISON, EILEEN M (LCSW)
Entity Type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:M
Last Name:COLLISON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:EDW HINES VA HOSPITAL, P.O. BOX 5000
Mailing Address - Street 2:#116
Mailing Address - City:HINES,
Mailing Address - State:IL
Mailing Address - Zip Code:60141
Mailing Address - Country:US
Mailing Address - Phone:708-202-2109
Mailing Address - Fax:708-202-2108
Practice Address - Street 1:EDW HINES VA HOSPITAL, MENTAL HEALTH CLINIC
Practice Address - Street 2:#116
Practice Address - City:HINES,
Practice Address - State:IL
Practice Address - Zip Code:60141
Practice Address - Country:US
Practice Address - Phone:708-202-2109
Practice Address - Fax:708-202-2108
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical