Provider Demographics
NPI:1629166640
Name:DROEL, MARY A (LCSW)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:A
Last Name:DROEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:A
Other - Last Name:GALLAGHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3422 W 59TH PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60629-3625
Mailing Address - Country:US
Mailing Address - Phone:773-471-3295
Mailing Address - Fax:708-283-8073
Practice Address - Street 1:2050 CLAIRE CT
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-7635
Practice Address - Country:US
Practice Address - Phone:708-283-8150
Practice Address - Fax:708-283-8073
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
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