Provider Demographics
NPI:1417251380
Name:ASHUM, ANNA N (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:N
Last Name:ASHUM
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15419 E 127TH ST
Mailing Address - Street 2:
Mailing Address - City:LEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60439-6494
Mailing Address - Country:US
Mailing Address - Phone:630-777-7113
Mailing Address - Fax:630-243-0317
Practice Address - Street 1:15419 E 127TH ST
Practice Address - Street 2:
Practice Address - City:LEMONT
Practice Address - State:IL
Practice Address - Zip Code:60439-6494
Practice Address - Country:US
Practice Address - Phone:630-777-7113
Practice Address - Fax:630-243-0317
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490126651041C0700X
IL1490188831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical