Provider Demographics
NPI:1669299848
Name:TOTONCHI, MLADENKA KOVACEVIC (LCSW)
Entity type:Individual
Prefix:
First Name:MLADENKA
Middle Name:KOVACEVIC
Last Name:TOTONCHI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MLADENKA
Other - Middle Name:
Other - Last Name:KOVACEVIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:29373 NETWORK PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-1293
Mailing Address - Country:US
Mailing Address - Phone:847-390-5900
Mailing Address - Fax:847-390-4757
Practice Address - Street 1:2535 S. MARTIN LUTHER KING JR DR
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616
Practice Address - Country:US
Practice Address - Phone:312-842-7117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-20
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0271491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical