Provider Demographics
NPI:1598896052
Name:PEEK, CHERYL LARICE (MSW)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:LARICE
Last Name:PEEK
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6336 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:IN
Mailing Address - Zip Code:46324-1013
Mailing Address - Country:US
Mailing Address - Phone:219-931-2716
Mailing Address - Fax:219-473-4277
Practice Address - Street 1:53 W JACKSON BLVD
Practice Address - Street 2:SUITE 1361
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60604-3606
Practice Address - Country:US
Practice Address - Phone:866-287-4851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
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