| Doctor Name: | MS. DIANE R FUNK |
| NPI Number: | 1184771420 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 149.006277 |
| Business Practice Address: | 2960 Chartres St La Salle, IL - 613011097 |
| Business Phone Number: | 8152230160 |
| Business Fax Number: | 8152231634 |
| Mailing Address: | 1401 Lakewood Dr A, MORRIS |
| State: | IL |
| Postal Code: | 604503352 |
| Phone Number: | 8159426323 |
| Fax Number: | 8159426423 |
| NPI Enumeration Date: | 01/05/2007 |
| NPI Last Update Date: | 10/27/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 149.006277 |
| 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 |