Provider Demographics
NPI:1568513562
Name:ISENBERG, SHELDON (LCSW)
Entity Type:Individual
Prefix:
First Name:SHELDON
Middle Name:
Last Name:ISENBERG
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 S. WASHINGTON STREET
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540
Mailing Address - Country:US
Mailing Address - Phone:630-355-8410
Mailing Address - Fax:630-355-8412
Practice Address - Street 1:236 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-5371
Practice Address - Country:US
Practice Address - Phone:630-355-8410
Practice Address - Fax:630-355-8412
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490006601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL344520Medicare ID - Type Unspecified