Provider Demographics
NPI:1750371183
Name:AHERN, PATRICK JOSEPH (JD LCSW)
Entity type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:JOSEPH
Last Name:AHERN
Suffix:
Gender:M
Credentials:JD LCSW
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Mailing Address - Street 1:2210 DEAN ST
Mailing Address - Street 2:STE O1
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60175-1066
Mailing Address - Country:US
Mailing Address - Phone:630-587-6910
Mailing Address - Fax:630-587-4928
Practice Address - Street 1:2210 DEAN ST
Practice Address - Street 2:STE O1
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60175-1066
Practice Address - Country:US
Practice Address - Phone:630-587-6910
Practice Address - Fax:630-587-4928
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-26
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL49006411104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL04532233OtherBLUE CROSS BLUE SHIELD
IL2080026OtherCIGNA BEHAVIORAL HEALTH