Provider Demographics
NPI:1922178409
Name:BAGLEY, MARGARET ANN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:ANN
Last Name:BAGLEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 HILLCREST DR E
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61571-2227
Mailing Address - Country:US
Mailing Address - Phone:309-472-7568
Mailing Address - Fax:309-444-2866
Practice Address - Street 1:13531 MCCABE DR
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467-6854
Practice Address - Country:US
Practice Address - Phone:708-466-7136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149-0107261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01635265OtherBLUECROSS IDENTIFICATION
IL01635265OtherBLUECROSS IDENTIFICATION