Provider Demographics
NPI:1689752057
Name:COLLINSON-PAUTZ, BARBARA J (LCSW)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:J
Last Name:COLLINSON-PAUTZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:BARBARA
Other - Middle Name:
Other - Last Name:COLLINSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:125 S WILKE RD
Mailing Address - Street 2:SUITE 200A
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-1534
Mailing Address - Country:US
Mailing Address - Phone:847-870-0771
Mailing Address - Fax:857-870-0770
Practice Address - Street 1:125 S WILKE RD
Practice Address - Street 2:SUITE 200A
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-1534
Practice Address - Country:US
Practice Address - Phone:847-870-0771
Practice Address - Fax:857-870-0770
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490016501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL208247Medicare ID - Type Unspecified
ILK03669Medicare PIN