Organization
TODD LAZAR LCSW LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TODD LAZAR LCSW (OWNER)
(312) 925-6366
Entity
Organization
Contact information
Practice address
2858 W DIVERSEY AVE, CHICAGO, IL 60647-1871
(312) 925-6366
Mailing address
2637 N WHIPPLE ST, CHICAGO, IL 60647-1721
(312) 925-6366
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
02/03/2020
Last updated
02/24/2020
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