Individual
LESSI J SMEBAKKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
970 MCHENRY AVE, CRYSTAL LAKE, IL 60014-7449
(815) 455-7100
(815) 455-3951
Mailing address
226 S VAIL AVE, ARLINGTON HEIGHTS, IL 60005-1845
(847) 363-2948
(847) 398-6213
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
149-005313
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05619771
BCBS
IL
Enumeration date
07/20/2005
Last updated
08/08/2022
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