Provider Demographics
NPI:1205970050
Name:KEVIN, MAUREEN (MSW)
Entity type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:
Last Name:KEVIN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 N WEST AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-2529
Mailing Address - Country:US
Mailing Address - Phone:630-941-8270
Mailing Address - Fax:630-941-8294
Practice Address - Street 1:257 N WEST AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-2529
Practice Address - Country:US
Practice Address - Phone:630-941-8270
Practice Address - Fax:630-941-8294
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
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