Provider Demographics
NPI:1598164402
Name:WHEELER, ERIN MUNDY (LCSW)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:MUNDY
Last Name:WHEELER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 N ORLEANS ST STE 206
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-3144
Mailing Address - Country:US
Mailing Address - Phone:312-809-0298
Mailing Address - Fax:
Practice Address - Street 1:820 N ORLEANS ST STE 206
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610-3144
Practice Address - Country:US
Practice Address - Phone:312-809-0298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-15
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490165981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical