Provider Demographics
NPI:1518049618
Name:STERZER, MICHAEL JAY (LCSW,ISW)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:JAY
Last Name:STERZER
Suffix:
Gender:M
Credentials:LCSW,ISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 ELLA AVE
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60433-2799
Mailing Address - Country:US
Mailing Address - Phone:815-727-8521
Mailing Address - Fax:815-727-8433
Practice Address - Street 1:501 ELLA AVE
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60433-2799
Practice Address - Country:US
Practice Address - Phone:815-727-8521
Practice Address - Fax:815-727-8433
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149-0002701041C0700X
OHI.05000791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL937031Medicare PIN
IL351740Medicare ID - Type UnspecifiedFCC/TRINITY SERVICES