Individual ProviderJoanna Kate LackayeSocial WorkerBehavioral Health & Social Service ProvidersPractice Address2736 N Southport Ave # 1, Chicago, IL 60614(573) 356-7909PECOS EnrollmentBased on the most recent information from CMS, provider Joanna Kate Lackaye does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1497043764Provider TypeIndividualFull NameLackaye, Joanna KateCredentialLCSWGenderFemaleSole ProprietorNoEnumeration Date7/20/2011Last Updated1/31/2019Contact InformationPractice LocationPractice Address2736 N Southport Ave # 1, Chicago, IL 60614Phone(573) 356-7909FaxUnlisted FaxMailing LocationMailing Address2736 N Southport Ave # 1, Chicago, IL 60614-1230Phone(573) 356-7909FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense149.015939IllinoisCode104100000XDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense150012886IllinoisProvider IdentifiersIDDescriptionIssuerID1616824DescriptionOtherIssuerBLUE SHIELDIllinois