Individual
AMY TANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
61 S OLD RAND RD, LAKE ZURICH, IL 60047-3127
(847) 438-4222
(847) 438-0844
Mailing address
5805 W EDDY ST, UNIT 1D, CHICAGO, IL 60634-4390
(773) 430-1075
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.011144
IL
Other
Enumeration date
01/29/2007
Last updated
02/13/2009
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