Provider Demographics
NPI:1184166407
Name:CHRISTINE MCCALL LCSW CADC LLC
Entity type:Organization
Organization Name:CHRISTINE MCCALL LCSW CADC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCALL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:312-909-9113
Mailing Address - Street 1:5925 N KENMORE AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-3645
Mailing Address - Country:US
Mailing Address - Phone:312-909-9113
Mailing Address - Fax:
Practice Address - Street 1:5756 N RIDGE AVE
Practice Address - Street 2:SUITE 14
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60660-5331
Practice Address - Country:US
Practice Address - Phone:312-909-9113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-17
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490168381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty