Provider Demographics
NPI:1851873160
Name:BILL, CYNTHIA ANN (LCSW, CRADC, CCTPII)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:ANN
Last Name:BILL
Suffix:
Gender:F
Credentials:LCSW, CRADC, CCTPII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1365 IVY LN APT 104
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-0478
Mailing Address - Country:US
Mailing Address - Phone:630-965-3949
Mailing Address - Fax:
Practice Address - Street 1:1365 IVY LN APT 104
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-0478
Practice Address - Country:US
Practice Address - Phone:630-965-3949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-04
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0222151041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL474579189001Medicaid