Doctor Name: | MR. JEFFREY L POLLACK |
NPI Number: | 1316381346 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW |
License Number: | 149005603 |
Business Practice Address: | 822 Dunlop Ave Forest Park, IL - 601302037 |
Business Phone Number: | 7734265578 |
Business Fax Number: | |
Mailing Address: | 1725 S Naperville Rd, Suite 206 WHEATON |
State: | IL |
Postal Code: | 601895855 |
Phone Number: | 6306536441 |
Fax Number: | 6306538409 |
NPI Enumeration Date: | 04/21/2013 |
NPI Last Update Date: | 04/21/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 149005603 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |