Provider Demographics
NPI:1518780212
Name:DAHLHEIMER, ISABELLA (LSW)
Entity type:Individual
Prefix:
First Name:ISABELLA
Middle Name:
Last Name:DAHLHEIMER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 N PINECREST RD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-2138
Mailing Address - Country:US
Mailing Address - Phone:217-372-4930
Mailing Address - Fax:
Practice Address - Street 1:526 CRESCENT BLVD STE 300
Practice Address - Street 2:
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137-4187
Practice Address - Country:US
Practice Address - Phone:630-981-7625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-02
Last Update Date:2024-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150112025104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker