Provider Demographics
NPI:1104380336
Name:GILES, SARAJANE W (LCSW)
Entity Type:Individual
Prefix:
First Name:SARAJANE
Middle Name:W
Last Name:GILES
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:DEPARTMENT OF PSYCHIATRY
Mailing Address - Street 2:2650 RIDGE AVENUE
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-1718
Mailing Address - Country:US
Mailing Address - Phone:847-570-2540
Mailing Address - Fax:847-570-1405
Practice Address - Street 1:2650 RIDGE AVENUE
Practice Address - Street 2:DEPARTMENT OF PSYCHIATRY
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-1718
Practice Address - Country:US
Practice Address - Phone:505-983-5896
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-22
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical