Provider Demographics
NPI:1881451904
Name:WILLIAMS, NAZREE DIANE (LSW)
Entity type:Individual
Prefix:
First Name:NAZREE
Middle Name:DIANE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28W470 WYNN AVE
Mailing Address - Street 2:
Mailing Address - City:WEST CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60185-1425
Mailing Address - Country:US
Mailing Address - Phone:312-888-5160
Mailing Address - Fax:
Practice Address - Street 1:1135 BOWES RD
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-5541
Practice Address - Country:US
Practice Address - Phone:847-931-6234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.112956101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health