Provider Demographics
NPI:1659461192
Name:WERTYMER, KAREN D (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:D
Last Name:WERTYMER
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 1:50 E WASHINGTON ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-2152
Mailing Address - Country:US
Mailing Address - Phone:312-252-9500
Mailing Address - Fax:312-337-9243
Practice Address - Street 1:50 E WASHINGTON ST
Practice Address - Street 2:SUITE 301
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-2152
Practice Address - Country:US
Practice Address - Phone:312-252-9500
Practice Address - Fax:312-337-9243
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149000692101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK17975Medicare ID - Type UnspecifiedCLINICAL SOCIAL WORKER