Provider Demographics
NPI:1710595210
Name:NEAL, CAROLINE PIA ELIZABETH
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:PIA ELIZABETH
Last Name:NEAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2644 N WASHTENAW AVE # 2D
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-1836
Mailing Address - Country:US
Mailing Address - Phone:920-360-6114
Mailing Address - Fax:
Practice Address - Street 1:120 E OGDEN AVE STE 220
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3886
Practice Address - Country:US
Practice Address - Phone:630-325-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-21
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist