Provider Demographics
NPI:1437282985
Name:SEIDMAN, ROBYN KAPLAN (LCSW)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:KAPLAN
Last Name:SEIDMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ROBYN
Other - Middle Name:
Other - Last Name:SEIDMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:826 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:RIVER FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60305-1362
Mailing Address - Country:US
Mailing Address - Phone:708-752-0867
Mailing Address - Fax:
Practice Address - Street 1:1623 N WESTERN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-5321
Practice Address - Country:US
Practice Address - Phone:708-446-5520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149-0087921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL149-008792OtherLCSW
708270Medicare ID - Type Unspecified