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Organization
LIFESKILLS CENTER, LTD
Active
Organization
LIFESKILLS CENTER, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN A WHITE LCSW (OWNER)
(224) 577-5022
Entity
Organization
Contact information
Practice address
479 NORTH AVE, ANTIOCH, IL 60002-1323
(224) 577-5022
(847) 395-9551
Mailing address
479 NORTH AVE, ANTIOCH, IL 60002-1323
(224) 577-5022
(847) 395-9551
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149011526
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11722321
CAQH
IL
01
—
1508919812
NPI TYPE 1
IL
Enumeration date
05/24/2007
Last updated
08/18/2023
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