Provider Demographics
NPI:1366555476
Name:KALLMANN, LYNN (LCSW)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:KALLMANN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 W JACKSON AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-5256
Mailing Address - Country:US
Mailing Address - Phone:630-717-1157
Mailing Address - Fax:480-563-4478
Practice Address - Street 1:445 W JACKSON AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-5256
Practice Address - Country:US
Practice Address - Phone:630-717-1157
Practice Address - Fax:480-563-4478
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical