Provider Demographics
NPI:1821072273
Name:MCINTYRE, LYNN M (PHD LCSW)
Entity Type:Individual
Prefix:DR
First Name:LYNN
Middle Name:M
Last Name:MCINTYRE
Suffix:
Gender:F
Credentials:PHD LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3750 N LAKE SHORE DR
Mailing Address - Street 2:2G
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-4238
Mailing Address - Country:US
Mailing Address - Phone:847-356-3310
Mailing Address - Fax:
Practice Address - Street 1:100 N WAUKEGAN RD
Practice Address - Street 2:STE 201
Practice Address - City:LAKE BLUFF
Practice Address - State:IL
Practice Address - Zip Code:60044-1694
Practice Address - Country:US
Practice Address - Phone:847-356-3310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490029481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical