Provider Demographics
NPI:1003137738
Name:SHAMBERG, HOPE (LCSW)
Entity Type:Individual
Prefix:
First Name:HOPE
Middle Name:
Last Name:SHAMBERG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1151 WARRINGTON RD
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-3142
Mailing Address - Country:US
Mailing Address - Phone:847-317-0506
Mailing Address - Fax:
Practice Address - Street 1:459 CENTRAL AVE
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-2622
Practice Address - Country:US
Practice Address - Phone:773-203-1855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-16
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149-0086351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical