Provider Demographics
NPI:1205087731
Name:PIEROZZI-MATUSEK, CHRISTINE M (LCSW)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:M
Last Name:PIEROZZI-MATUSEK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:M
Other - Last Name:PIEROZZI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:1701 E. WOODFIELD ROAD
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-5113
Mailing Address - Country:US
Mailing Address - Phone:847-240-2211
Mailing Address - Fax:847-240-2418
Practice Address - Street 1:3 HAWTHORN PKWY
Practice Address - Street 2:SUITE 260
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1446
Practice Address - Country:US
Practice Address - Phone:847-918-8282
Practice Address - Fax:847-918-8215
Is Sole Proprietor?:No
Enumeration Date:2008-10-02
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149-0126301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1633897OtherGROUP BCBS NUMBER
IL1679546873OtherGROUP NPI NUMBER
IL207844OtherMEDICARE GROUP NUMBER