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Individual

DR. EARNEST WEBB JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSW PHD

Contact information

Practice address
849 MAPLE AVE., 903, HOMEWOOD, IL 60430-2068
(708) 799-5862
(708) 799-0138
Mailing address
849 MAPLE AVE., 903, HOMEWOOD, IL 60430-2068
(708) 799-5862
(708) 799-0138

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149005899
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0001605394
BLUE CROSS BLUE SHEILD #
IL
01
182725
VALUE OPTION PROVIDER #
IL
Enumeration date
03/06/2007
Last updated
10/31/2011
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