Provider Demographics
NPI:1679717094
Name:KATZ, ANITA SHIRLEY (MSW/LCSW)
Entity type:Individual
Prefix:MRS
First Name:ANITA
Middle Name:SHIRLEY
Last Name:KATZ
Suffix:
Gender:F
Credentials:MSW/LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6121 N. SHERIDAN ROAD
Mailing Address - Street 2:APT, 5B
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660
Mailing Address - Country:US
Mailing Address - Phone:773-274-0667
Mailing Address - Fax:
Practice Address - Street 1:6121 N. SHERIDAN ROAD
Practice Address - Street 2:APT. 5B
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60660
Practice Address - Country:US
Practice Address - Phone:773-274-0667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-29
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILIL149-0025641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical