Tillack, Carolyn
Tillack, Carolyn is an sole proprietor health care provider with primary practice located at 317 W Colfax St Suite 111, Palatine IL 60067-2535. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Tillack, Carolyn can be contacted via phone (847) 507-3352.Contact Information
Primary practice address
317 W Colfax St Suite 111
Palatine IL 60067-2535
Phone: (847) 507-3352
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 149-001630 | Illinois |
Profile Details
| NPI number | 1699792481 |
|---|---|
| LBN Legal business name | Tillack, Carolyn |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 16th, 2006 |
| Last updated | Feb 24th, 2014 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1699792481 | NPPES |
| Illinois | Other | 149-001630 | LIC.CLINICAL SOC. WKR. |
| Illinois | Other | 0162-6486 | LIC.CLINICAL SOC. WKR. |
| Illinois | Other | 115 392 13 | LIC.CLINICAL SOC. WKR. |
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