Provider Demographics
NPI:1295826162
Name:GROSS, DEBORAH L (MSW)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:L
Last Name:GROSS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3255 N ARLINGTON HEIGHTS RD
Mailing Address - Street 2:SUITE 502
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-1586
Mailing Address - Country:US
Mailing Address - Phone:847-253-5352
Mailing Address - Fax:847-537-7941
Practice Address - Street 1:3255 N ARLINGTON HEIGHTS RD
Practice Address - Street 2:SUITE 502
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-1586
Practice Address - Country:US
Practice Address - Phone:847-253-5352
Practice Address - Fax:847-537-7941
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical