Individual
MRS. BERNICE O BANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.C.S.W.
Contact information
Practice address
1525 E 53RD ST, SUITE 411, CHICAGO, IL 60615-4557
(773) 493-9477
(773) 734-4924
Mailing address
1525 E 53RD ST, SUITE 411, CHICAGO, IL 60615-4557
(773) 493-9477
(773) 734-4924
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01638407
BLUE CROSS BLUE SHIELD
IL
Enumeration date
12/11/2007
Last updated
01/31/2008
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