Provider Demographics
NPI:1225392798
Name:JORI RISKE LCSW, LTD.
Entity Type:Organization
Organization Name:JORI RISKE LCSW, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JORI
Authorized Official - Middle Name:
Authorized Official - Last Name:RISKE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:847-489-7282
Mailing Address - Street 1:209 E PARK ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:MUNDELEIN
Mailing Address - State:IL
Mailing Address - Zip Code:60060-1972
Mailing Address - Country:US
Mailing Address - Phone:224-360-0688
Mailing Address - Fax:
Practice Address - Street 1:209 E PARK ST
Practice Address - Street 2:SUITE B
Practice Address - City:MUNDELEIN
Practice Address - State:IL
Practice Address - Zip Code:60060-1972
Practice Address - Country:US
Practice Address - Phone:224-360-0688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-29
Last Update Date:2012-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490086381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty