Provider Demographics
NPI:1205046521
Name:QUEHL, PATRICE KAREN (MA, LMFT, LCSW)
Entity type:Individual
Prefix:MS
First Name:PATRICE
Middle Name:KAREN
Last Name:QUEHL
Suffix:
Gender:F
Credentials:MA, LMFT, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 W AINSLIE ST APT 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-3820
Mailing Address - Country:US
Mailing Address - Phone:312-208-5620
Mailing Address - Fax:
Practice Address - Street 1:1 E SUPERIOR ST STE 500
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2507
Practice Address - Country:US
Practice Address - Phone:312-208-5620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149-0081751041C0700X
IL166.000542106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical