Provider Demographics
NPI:1083775597
Name:ESSER, MICHELE L (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:L
Last Name:ESSER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:MICHELE
Other - Middle Name:L
Other - Last Name:BLOCK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:3010 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:WAUKEGAN
Mailing Address - State:IL
Mailing Address - Zip Code:60085-2321
Mailing Address - Country:US
Mailing Address - Phone:847-377-8971
Mailing Address - Fax:847-984-5602
Practice Address - Street 1:3010 GRAND AVE
Practice Address - Street 2:
Practice Address - City:WAUKEGAN
Practice Address - State:IL
Practice Address - Zip Code:60085-2321
Practice Address - Country:US
Practice Address - Phone:847-377-8971
Practice Address - Fax:847-984-5602
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0107921041C0700X
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40936300Medicaid