Provider Demographics
NPI:1871938928
Name:PATRICK J. AHERN, J.D., L.C.S.W., P.C.
Entity type:Organization
Organization Name:PATRICK J. AHERN, J.D., L.C.S.W., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:J
Authorized Official - Last Name:AHERN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:630-587-6910
Mailing Address - Street 1:2210 DEAN ST
Mailing Address - Street 2:SUITE O-1
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60175-1066
Mailing Address - Country:US
Mailing Address - Phone:630-587-6910
Mailing Address - Fax:630-587-4928
Practice Address - Street 1:2210 DEAN ST
Practice Address - Street 2:SUITE O-1
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60175-1066
Practice Address - Country:US
Practice Address - Phone:630-587-6910
Practice Address - Fax:630-587-4928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-02
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149-006411261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health