Provider Demographics
NPI:1790504991
Name:HORNUNG, MAX P (LCSW)
Entity type:Individual
Prefix:
First Name:MAX
Middle Name:P
Last Name:HORNUNG
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 S WABASH AVE APT 17
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-4826
Mailing Address - Country:US
Mailing Address - Phone:773-490-8660
Mailing Address - Fax:
Practice Address - Street 1:2323 S WABASH AVE APT 17
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-4826
Practice Address - Country:US
Practice Address - Phone:773-490-8660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0275551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty