Provider Demographics
NPI:1043314495
Name:KRASNER, GERALDINE COOPER (LCSW)
Entity Type:Individual
Prefix:
First Name:GERALDINE
Middle Name:COOPER
Last Name:KRASNER
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 1:5225 OLD ORCHARD RD.
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-1027
Mailing Address - Country:US
Mailing Address - Phone:847-965-8155
Mailing Address - Fax:847-256-9440
Practice Address - Street 1:5225 OLD ORCHARD RD.
Practice Address - Street 2:SUITE 1
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-1027
Practice Address - Country:US
Practice Address - Phone:847-965-8155
Practice Address - Fax:847-256-9440
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical