Doctor Name: | MS. MARY E. CHERULLO |
NPI Number: | 1073757134 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 149.013561 |
Business Practice Address: | 5000 S. 5th Ave Building 228 Tinley Park, IL - 604143030 |
Business Phone Number: | 7738700251 |
Business Fax Number: | |
Mailing Address: | 5000 S 5th Ave, Building 228 HINES |
State: | IL |
Postal Code: | 601413030 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 04/20/2009 |
NPI Last Update Date: | 06/14/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 149.013561 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |