Provider Demographics
NPI:1760682801
Name:PEET, RUBY C (LCSW)
Entity Type:Individual
Prefix:MS
First Name:RUBY
Middle Name:C
Last Name:PEET
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2220 S KEDVALE AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60623-2812
Mailing Address - Country:US
Mailing Address - Phone:773-983-4495
Mailing Address - Fax:773-752-7739
Practice Address - Street 1:2220 S KEDVALE AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60623-2812
Practice Address - Country:US
Practice Address - Phone:773-983-4495
Practice Address - Fax:773-752-7739
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-18
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490057721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical