Provider Demographics
NPI:1952609141
Name:PERRY, DANETTE (MBA,MSW,LSW)
Entity Type:Individual
Prefix:MS
First Name:DANETTE
Middle Name:
Last Name:PERRY
Suffix:
Gender:F
Credentials:MBA,MSW,LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 S GRANT ST
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-4455
Mailing Address - Country:US
Mailing Address - Phone:630-437-1030
Mailing Address - Fax:
Practice Address - Street 1:2 MID AMERICA PLZ STE 800
Practice Address - Street 2:
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181-4727
Practice Address - Country:US
Practice Address - Phone:630-437-1030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-11
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.012363104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL150.012363OtherLICENSED SOCIAL WORKER, MASTERS