Provider Demographics
NPI:1144594474
Name:ADELMAN, CAROLINE BLISS (PHD)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:BLISS
Last Name:ADELMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:BLISS
Other - Last Name:BROWNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1925 N CLYBOURN AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-7395
Mailing Address - Country:US
Mailing Address - Phone:773-697-8839
Mailing Address - Fax:
Practice Address - Street 1:1925 N CLYBOURN AVE STE 300
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-7395
Practice Address - Country:US
Practice Address - Phone:773-697-8839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-05
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.008925103TC2200X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent