Provider Demographics
NPI:1952691180
Name:TRUJILLO, CONNIE LEANN (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:CONNIE
Middle Name:LEANN
Last Name:TRUJILLO
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:MS
Other - First Name:CONNIE
Other - Middle Name:LEANN
Other - Last Name:MCCARTHY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:5151 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-1123
Mailing Address - Country:US
Mailing Address - Phone:847-933-9200
Mailing Address - Fax:
Practice Address - Street 1:5151 CHURCH ST
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-1123
Practice Address - Country:US
Practice Address - Phone:847-933-9200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-08
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0137731041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical