Provider Demographics
NPI:1205188778
Name:PERIC, NATASA (LMSW MSSW)
Entity Type:Individual
Prefix:
First Name:NATASA
Middle Name:
Last Name:PERIC
Suffix:
Gender:F
Credentials:LMSW MSSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:867 N DEARBORN ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-3310
Mailing Address - Country:US
Mailing Address - Phone:312-943-3534
Mailing Address - Fax:
Practice Address - Street 1:867 N DEARBORN ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610-3310
Practice Address - Country:US
Practice Address - Phone:312-943-3534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-09
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker