Provider Demographics
NPI:1720337744
Name:SACCHETTI, VICTORIA K (LSW)
Entity Type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:K
Last Name:SACCHETTI
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:W
Other - Last Name:KRONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3227 N CLIFTON AVE
Mailing Address - Street 2:UNIT 3
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-3318
Mailing Address - Country:US
Mailing Address - Phone:847-987-8679
Mailing Address - Fax:
Practice Address - Street 1:522 CHESTNUT ST
Practice Address - Street 2:SUITE 2D
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3171
Practice Address - Country:US
Practice Address - Phone:630-214-0476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-05
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL20-466905104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL20-466905OtherTAX ID