Doctor Name: | MAUREEN DORGAN CLEMENS |
NPI Number: | 1124141866 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 175 Olde Half Day Rd Suite 130 Lincolnshire, IL - 600693061 |
Business Phone Number: | 8662965262 |
Business Fax Number: | 8477932437 |
Mailing Address: | 20 N Clark St, Suite 2650 CHICAGO |
State: | IL |
Postal Code: | 606024109 |
Phone Number: | 8662965262 |
Fax Number: | 3125581570 |
NPI Enumeration Date: | 04/09/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |