Individual
AILEEN KELLEHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1502 W CHICAGO AVE, CHICAGO, IL 60642-5236
(312) 351-0395
Mailing address
2714 W EVERGREEN AVE, CHICAGO, IL 60622-2822
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.021321
IL
Other
Enumeration date
06/14/2019
Last updated
06/14/2019
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