Provider Demographics
NPI:1558605220
Name:LOEHR, MICHAEL ALLEN (MSW, LCSW)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:ALLEN
Last Name:LOEHR
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1010 LAKE ST
Mailing Address - Street 2:SUITE 501A
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60301-1147
Mailing Address - Country:US
Mailing Address - Phone:708-406-9166
Mailing Address - Fax:312-694-0872
Practice Address - Street 1:1010 LAKE ST
Practice Address - Street 2:SUITE 501A
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-1147
Practice Address - Country:US
Practice Address - Phone:708-406-9166
Practice Address - Fax:312-694-0872
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-19
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL1490154621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical