Individual
BENJAMIN FOGEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
53 W JACKSON BLVD, STE 841, CHICAGO, IL 60604-3828
(312) 478-3999
Mailing address
2443 N SAWYER AVE, APT 1S, CHICAGO, IL 60647-2517
(312) 478-3999
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.015487
IL
Other
Enumeration date
06/16/2014
Last updated
02/04/2019
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