Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Alza Great Lakes Psychotherapy Professional LLC

Organization Clinical Social Worker · NPI 1720812860

Alza Great Lakes Psychotherapy Professional LLC is a Clinical Social Worker in Chicago, Illinois. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1719 N Rutherford Ave
Chicago, IL 60707-3942
Phone: (708) 824-7533
Fax: (312) 748-4256
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X

Record details

NPI number1720812860
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ena Milllward — Lcsw · (773) 707-6093
NPI enumeratedAugust 30, 2024
Last updated in NPPESFebruary 12, 2025
Certification dateFebruary 12, 2025
Mailing address7061 North Ave # 292, Oak Park, IL 60302-1015

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