Provider Demographics
NPI:1730524356
Name:PRICE, WAYNE F (MSW)
Entity type:Individual
Prefix:MR
First Name:WAYNE
Middle Name:F
Last Name:PRICE
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2S166 LLOYD AVE
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-7900
Mailing Address - Country:US
Mailing Address - Phone:630-715-2356
Mailing Address - Fax:
Practice Address - Street 1:2S166 LLOYD AVE
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-7900
Practice Address - Country:US
Practice Address - Phone:630-715-2356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-09
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490075361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical