Organization
ETHAN ISRAELSOHN, LCSW, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ETHAN ISRAELSOHN LCSW (OWNER)
(708) 848-0112
Entity
Organization
Contact information
Practice address
715 LAKE ST, SUITE 710, OAK PARK, IL 60301-1422
(708) 848-0112
(708) 386-4211
Mailing address
518 HIGHLAND AVE, OAK PARK, IL 60304-1523
(708) 848-0112
(708) 386-4211
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149-007781
IL
Other
Enumeration date
01/10/2007
Last updated
09/03/2020
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