Provider Demographics
NPI:1710191036
Name:NATHANSON, FRANCES IRENE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:FRANCES
Middle Name:IRENE
Last Name:NATHANSON
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 1:4101 N RAVENSWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-2193
Mailing Address - Country:US
Mailing Address - Phone:773-281-3800
Mailing Address - Fax:773-281-8790
Practice Address - Street 1:2700 N LAKEVIEW AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-3488
Practice Address - Country:US
Practice Address - Phone:773-281-3800
Practice Address - Fax:773-281-8790
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
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
IL0031648924OtherEXISTING BCBS PROVIDER #