Petty, Mary Lou

Petty, Mary Lou is an individual health care provider with primary practice located at 30 N Michigan Ave Ste 1004, Chicago IL 60602-3402. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Petty, Mary Lou can be contacted via phone (312) 236-4364.

Contact Information

Primary practice address
30 N Michigan Ave Ste 1004 Chicago IL 60602-3402
Phone: (312) 236-4364
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X Illinois

Profile Details

NPI number 1598747461
LBN Legal business name Petty, Mary Lou
Credentials MSW LCSW
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 16th, 2005
Last updated Jul 13th, 2026 - about 3 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1598747461 NPPES
Other 0005983663 AETNA
Other 190629 AETNA
Other 5906676720 AETNA
Other 01673624 AETNA

Popular Providers