Provider Demographics
NPI:1821206327
Name:MCFIELD, LATANYA MARIE
Entity Type:Individual
Prefix:
First Name:LATANYA
Middle Name:MARIE
Last Name:MCFIELD
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 1:17911 LOS ANGELES AVE
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-1509
Mailing Address - Country:US
Mailing Address - Phone:773-807-2144
Mailing Address - Fax:
Practice Address - Street 1:400 E 41ST ST
Practice Address - Street 2:SUITE 101A
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60653-3071
Practice Address - Country:US
Practice Address - Phone:773-807-2144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2015-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180006065103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities