Provider Demographics
NPI:1538317458
Name:KAROFF, ANDREA (LCSW, OSW-C)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:KAROFF
Suffix:
Gender:F
Credentials:LCSW, OSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1860 SHERMAN AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-3758
Mailing Address - Country:US
Mailing Address - Phone:847-328-2627
Mailing Address - Fax:
Practice Address - Street 1:901 W WELLINGTON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-6708
Practice Address - Country:US
Practice Address - Phone:773-296-7180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149007560261QX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0200XAmbulatory Health Care FacilitiesClinic/CenterOncology