Provider Demographics
NPI:1134538390
Name:DURKIN, CONNOR (LCSW)
Entity type:Individual
Prefix:MR
First Name:CONNOR
Middle Name:
Last Name:DURKIN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1831 BAY SCOTT CIR STE 105
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-1115
Mailing Address - Country:US
Mailing Address - Phone:630-305-0464
Mailing Address - Fax:
Practice Address - Street 1:1831 BAY SCOTT CIR STE 105
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-1115
Practice Address - Country:US
Practice Address - Phone:630-305-0464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-12
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490168101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical