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Individual

LAUREN MICHELLE BANICKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LSW

Contact information

Practice address
11560 S KEDZIE AVE STE 200NA, MERRIONETTE PARK, IL 60803-4517
(708) 974-5147
(708) 974-2498
Mailing address
11560 S KEDZIE AVE STE 200NA, MERRIONETTE PARK, IL 60803-4517
(708) 974-5147

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

Enumeration date
02/21/2025
Last updated
02/21/2025
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