Provider Demographics
NPI:1972950806
Name:OATLEY, EMILY (LSW)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:OATLEY
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2420 N KEDZIE BLVD APT 101
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-5738
Mailing Address - Country:US
Mailing Address - Phone:805-458-5808
Mailing Address - Fax:
Practice Address - Street 1:2420 N KEDZIE BLVD APT 101
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-5738
Practice Address - Country:US
Practice Address - Phone:805-458-5808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-20
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
IL150.103998104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator