Provider Demographics
NPI:1669240479
Name:RECKER, CARLI SUSAN (LSW)
Entity type:Individual
Prefix:MRS
First Name:CARLI
Middle Name:SUSAN
Last Name:RECKER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:MS
Other - First Name:CARLI
Other - Middle Name:SUSAN
Other - Last Name:WHITCHURCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7399 FOREST HILLS RD
Mailing Address - Street 2:
Mailing Address - City:LOVES PARK
Mailing Address - State:IL
Mailing Address - Zip Code:61111-3974
Mailing Address - Country:US
Mailing Address - Phone:815-708-7392
Mailing Address - Fax:815-708-8248
Practice Address - Street 1:7399 FOREST HILLS RD
Practice Address - Street 2:
Practice Address - City:LOVES PARK
Practice Address - State:IL
Practice Address - Zip Code:61111-3974
Practice Address - Country:US
Practice Address - Phone:815-708-7392
Practice Address - Fax:815-708-8248
Is Sole Proprietor?:No
Enumeration Date:2023-12-12
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1500157991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical