Provider Demographics
NPI:1255824116
Name:ADESANYA, DELLIAH RENEE (LCSW)
Entity type:Individual
Prefix:
First Name:DELLIAH
Middle Name:RENEE
Last Name:ADESANYA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 S WACKER DR STE 300
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60606-4421
Mailing Address - Country:US
Mailing Address - Phone:312-835-7039
Mailing Address - Fax:469-421-8594
Practice Address - Street 1:125 S WACKER DR STE 300
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60606-4421
Practice Address - Country:US
Practice Address - Phone:312-835-7039
Practice Address - Fax:469-421-8594
Is Sole Proprietor?:No
Enumeration Date:2018-06-14
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0238361041C0700X
TX1099871041C0700X
MI68011186461041C0700X
IN34011437A1041C0700X
PACW0252261041C0700X
IL248.0039701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical