Provider Demographics
NPI:1801564968
Name:CALDERO, LILY
Entity type:Individual
Prefix:
First Name:LILY
Middle Name:
Last Name:CALDERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3732 N CENTRAL PARK AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-4109
Mailing Address - Country:US
Mailing Address - Phone:773-621-8553
Mailing Address - Fax:
Practice Address - Street 1:10001 GRAND AVE STE 1
Practice Address - Street 2:
Practice Address - City:FRANKLIN PARK
Practice Address - State:IL
Practice Address - Zip Code:60131-2564
Practice Address - Country:US
Practice Address - Phone:847-451-0330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-02
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker