Provider Demographics
NPI:1518097922
Name:SCHWASS, SUSAN GALLAGHER (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:GALLAGHER
Last Name:SCHWASS
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 1:730 GARLAND PL
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-4723
Mailing Address - Country:US
Mailing Address - Phone:847-824-6355
Mailing Address - Fax:
Practice Address - Street 1:4600 N HARLEM AVE
Practice Address - Street 2:
Practice Address - City:HARWOOD HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60706-4714
Practice Address - Country:US
Practice Address - Phone:708-867-6886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
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