Individual
MS. HEATHER MARIE LACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4711 GOLF RD STE 1100, SKOKIE, IL 60076-1249
(847) 933-9339
Mailing address
1412 US HIGHWAY 45 N, ELDORADO, IL 62930-3766
(708) 288-5936
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071010428
IL
Other
Enumeration date
03/28/2019
Last updated
12/14/2020
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