Provider Demographics
NPI:1437204641
Name:SHILVOCK-CINEFRO, KAREN LYDIA (LSW, NHA)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:LYDIA
Last Name:SHILVOCK-CINEFRO
Suffix:
Gender:F
Credentials:LSW, NHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17810 STREIT RD
Mailing Address - Street 2:
Mailing Address - City:HARVARD
Mailing Address - State:IL
Mailing Address - Zip Code:60033-9451
Mailing Address - Country:US
Mailing Address - Phone:847-363-3042
Mailing Address - Fax:
Practice Address - Street 1:17810 STREIT RD
Practice Address - Street 2:
Practice Address - City:HARVARD
Practice Address - State:IL
Practice Address - Zip Code:60033-9451
Practice Address - Country:US
Practice Address - Phone:847-363-3042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker