Provider Demographics
NPI:1740481936
Name:MARKOVITZ, DEBRA ANN (LCSW)
Entity type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:ANN
Last Name:MARKOVITZ
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 1:710 S PAULINA ST
Mailing Address - Street 2:SUITE 424
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3808
Mailing Address - Country:US
Mailing Address - Phone:312-942-3987
Mailing Address - Fax:312-942-3987
Practice Address - Street 1:710 S PAULINA ST
Practice Address - Street 2:SUITE 424
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3808
Practice Address - Country:US
Practice Address - Phone:312-942-3987
Practice Address - Fax:312-942-3987
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149-0105371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL149-010537OtherSOCIAL WORK LICENSE