Provider Demographics
NPI:1568571503
Name:CARDANI, ANDREA LYNN (MS MSW LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:LYNN
Last Name:CARDANI
Suffix:
Gender:F
Credentials:MS MSW LCSW
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1401 REGENCY DR E
Mailing Address - Street 2:STE A
Mailing Address - City:SAVOY
Mailing Address - State:IL
Mailing Address - Zip Code:61874
Mailing Address - Country:US
Mailing Address - Phone:217-398-1477
Mailing Address - Fax:217-239-2331
Practice Address - Street 1:1401 REGENCY DR E
Practice Address - Street 2:STE A
Practice Address - City:SAVOY
Practice Address - State:IL
Practice Address - Zip Code:61874
Practice Address - Country:US
Practice Address - Phone:217-398-1477
Practice Address - Fax:217-239-2331
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
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
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL210557Medicare ID - Type Unspecified