Provider Demographics
NPI:1144603499
Name:BLINDERMAN, POLINA (LCSW)
Entity Type:Individual
Prefix:
First Name:POLINA
Middle Name:
Last Name:BLINDERMAN
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 1:333 N MICHIGAN AVE STE 1900
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-3994
Mailing Address - Country:US
Mailing Address - Phone:773-321-2726
Mailing Address - Fax:
Practice Address - Street 1:3139 N LINCOLN AVE STE 226
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-3173
Practice Address - Country:US
Practice Address - Phone:847-917-4359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-06
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical