Provider Demographics
NPI:1699853747
Name:KAPLAN, THOMAS J (LCSW)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:J
Last Name:KAPLAN
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 1:425 CARRIAGE WAY
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-4532
Mailing Address - Country:US
Mailing Address - Phone:847-945-3308
Mailing Address - Fax:847-945-3962
Practice Address - Street 1:1830 SHERMAN AVE
Practice Address - Street 2:SUITE 306
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-3798
Practice Address - Country:US
Practice Address - Phone:847-328-7070
Practice Address - Fax:847-945-3962
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
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
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01673461OtherBLUE CROSS/BLUE SHIELD