Provider Demographics
NPI:1558734343
Name:RADOMSKI, CHRISTINE M (LCSW)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:M
Last Name:RADOMSKI
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 1:917 W WASHINGTON BLVD
Mailing Address - Street 2:SUITE 113
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-2203
Mailing Address - Country:US
Mailing Address - Phone:309-306-1630
Mailing Address - Fax:
Practice Address - Street 1:917 W WASHINGTON BLVD
Practice Address - Street 2:SUITE 113
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-2203
Practice Address - Country:US
Practice Address - Phone:309-306-1630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-03
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490150561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical