Provider Demographics
NPI:1952535569
Name:THORNTON, JULI (LSW, ACBSW)
Entity type:Individual
Prefix:
First Name:JULI
Middle Name:
Last Name:THORNTON
Suffix:
Gender:F
Credentials:LSW, ACBSW
Other - Prefix:
Other - First Name:JULI
Other - Middle Name:
Other - Last Name:TAUBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSW
Mailing Address - Street 1:113 OAKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-2828
Mailing Address - Country:US
Mailing Address - Phone:630-759-3604
Mailing Address - Fax:
Practice Address - Street 1:985 LILY CACHE LN
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-3131
Practice Address - Country:US
Practice Address - Phone:630-759-3604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-11
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.011719104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker