Individual
MS. EITHNE MARY KIELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1101 31ST ST STE 105, DOWNERS GROVE, IL 60515-5535
(773) 383-9051
(630) 926-0640
Mailing address
321 W CALENDAR AVE, APT 3F, LA GRANGE, IL 60525-2307
(773) 383-9051
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149017739
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
149.017739
LCSW
IL
Enumeration date
02/06/2017
Last updated
10/10/2023
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