Lisa M Pertile, LCSW

Individual provider Active NPI Clinical Social Worker · Worth, IL

NPI 1366485641 · NPPES record last updated Jul 2, 2014

Key facts

NPI
1366485641
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
149009385 (IL)
Practice address
111S1 S New England
Worth Junior High
Worth, IL 60482
Phone
(708) 448-2803
Fax
(708) 448-6155
NPI assigned
Jun 14, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149009385 IL Yes

Addresses

Primary practice location

111S1 S New England
Worth Junior High
Worth, IL 60482

Mailing address

5327 Fair Elms
Western Springs, IL 60558

Other providers in Worth, IL

All providers in Worth, IL · Clinical Social Worker in Illinois

Sources for this page

Verify at the official NPI Registry.