Provider Demographics
NPI:1528602638
Name:ADAMS, LUCRETIA (MHP)
Entity Type:Individual
Prefix:
First Name:LUCRETIA
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15124 DORCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:DOLTON
Mailing Address - State:IL
Mailing Address - Zip Code:60419-2942
Mailing Address - Country:US
Mailing Address - Phone:773-875-5210
Mailing Address - Fax:
Practice Address - Street 1:140 N ASHLAND AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-1802
Practice Address - Country:US
Practice Address - Phone:312-850-0050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-31
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty