Provider Demographics
NPI:1265177273
Name:NORDEN, DANA BATES
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:BATES
Last Name:NORDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 S MICHIGAN AVE STE 928
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-1399
Mailing Address - Country:US
Mailing Address - Phone:312-248-3190
Mailing Address - Fax:
Practice Address - Street 1:410 S MICHIGAN AVE STE 928
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-1399
Practice Address - Country:US
Practice Address - Phone:312-248-3190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-03
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.1051501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical