Provider Demographics
NPI:1790067494
Name:VENTURATO, GUY (LSW)
Entity Type:Individual
Prefix:
First Name:GUY
Middle Name:
Last Name:VENTURATO
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:696 RIENZI LN
Mailing Address - Street 2:
Mailing Address - City:HIGHWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60040-2024
Mailing Address - Country:US
Mailing Address - Phone:847-530-4064
Mailing Address - Fax:
Practice Address - Street 1:696 RIENZI LN
Practice Address - Street 2:
Practice Address - City:HIGHWOOD
Practice Address - State:IL
Practice Address - Zip Code:60040-2024
Practice Address - Country:US
Practice Address - Phone:847-530-4064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-19
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.013046104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker