Provider Demographics
NPI:1568217040
Name:PERK, DANIELLE (LSW)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:PERK
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15437 DEVONSHIRE LN
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-6736
Mailing Address - Country:US
Mailing Address - Phone:708-420-3934
Mailing Address - Fax:
Practice Address - Street 1:15437 DEVONSHIRE LN
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-6736
Practice Address - Country:US
Practice Address - Phone:708-420-3934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150112861104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker