Provider Demographics
NPI:1508987975
Name:ROSS, JOAN FORSTER (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:FORSTER
Last Name:ROSS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 N LAKE SHORE DR
Mailing Address - Street 2:APT 6 B
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-2827
Mailing Address - Country:US
Mailing Address - Phone:773-244-8142
Mailing Address - Fax:773-244-8143
Practice Address - Street 1:111 N WABASH AVE
Practice Address - Street 2:SUITE 1318
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-1903
Practice Address - Country:US
Practice Address - Phone:312-236-4436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical