Provider Demographics
NPI:1942419254
Name:FISCHER, LAUREENE ELLEN (LCSW)
Entity Type:Individual
Prefix:
First Name:LAUREENE
Middle Name:ELLEN
Last Name:FISCHER
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 1:20719 HUNT CLUB DR
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-1376
Mailing Address - Country:US
Mailing Address - Phone:815-806-1800
Mailing Address - Fax:
Practice Address - Street 1:621 ROLLINGWOOD DR
Practice Address - Street 2:
Practice Address - City:SHOREWOOD
Practice Address - State:IL
Practice Address - Zip Code:60431-0665
Practice Address - Country:US
Practice Address - Phone:815-725-5188
Practice Address - Fax:815-725-7550
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
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