Provider Demographics
NPI:1053552497
Name:CHAPMAN, PETER M (LCSW)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:M
Last Name:CHAPMAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5425 W LAKE ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60644-2342
Mailing Address - Country:US
Mailing Address - Phone:773-378-3347
Mailing Address - Fax:773-378-4028
Practice Address - Street 1:5425 W LAKE ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60644-2342
Practice Address - Country:US
Practice Address - Phone:773-378-3347
Practice Address - Fax:773-378-4028
Is Sole Proprietor?:No
Enumeration Date:2009-03-16
Last Update Date:2019-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490060771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical