Provider Demographics
NPI:1154485290
Name:JABS, CAROL ANN (PHD)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:ANN
Last Name:JABS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:ANN
Other - Last Name:SCHECTMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:904 LAKE AVENUE
Mailing Address - Street 2:
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091-1762
Mailing Address - Country:US
Mailing Address - Phone:847-251-2539
Mailing Address - Fax:708-209-3176
Practice Address - Street 1:7400 AUGUSTA STREET
Practice Address - Street 2:
Practice Address - City:RIVER FOREST
Practice Address - State:IL
Practice Address - Zip Code:60305-1402
Practice Address - Country:US
Practice Address - Phone:708-209-3145
Practice Address - Fax:708-209-3176
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490007241041C0700X
IL166000409106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0001632509OtherBCBS PROVIDER NUMBER