Provider Demographics
NPI:1891036893
Name:BAJAJ, DEANNE LOIS DRECHSLER (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DEANNE
Middle Name:LOIS DRECHSLER
Last Name:BAJAJ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DEANNE
Other - Middle Name:LOIS
Other - Last Name:DRECHSLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2604 RED ROCK RD
Mailing Address - Street 2:
Mailing Address - City:NORMAL
Mailing Address - State:IL
Mailing Address - Zip Code:61761-6438
Mailing Address - Country:US
Mailing Address - Phone:708-704-2585
Mailing Address - Fax:
Practice Address - Street 1:2422 E WASHINGTON ST STE 109
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61704-1611
Practice Address - Country:US
Practice Address - Phone:815-408-0202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-15
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0153911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical