Provider Demographics
NPI:1932116696
Name:MALING, JILL E (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JILL
Middle Name:E
Last Name:MALING
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 1:1519 DARTMOUTH LN
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-3942
Mailing Address - Country:US
Mailing Address - Phone:847-945-5333
Mailing Address - Fax:847-945-1372
Practice Address - Street 1:1519 DARTMOUTH LN
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-3942
Practice Address - Country:US
Practice Address - Phone:847-945-1170
Practice Address - Fax:847-945-1372
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1671159OtherBLUE CROSS/BLUE SHIELD