Provider Demographics
NPI:1609560440
Name:MCCANN, KATELYN (LSW)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:MCCANN
Suffix:
Gender:
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1528 W HURON ST APT 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60642-7307
Mailing Address - Country:US
Mailing Address - Phone:630-607-8157
Mailing Address - Fax:
Practice Address - Street 1:333 N MICHIGAN AVE STE 1400
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-4011
Practice Address - Country:US
Practice Address - Phone:312-815-9660
Practice Address - Fax:312-235-1999
Is Sole Proprietor?:No
Enumeration Date:2023-06-05
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.1143851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical