Provider Demographics
NPI:1790134039
Name:SWIDERSKA, DOROTHEA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DOROTHEA
Middle Name:
Last Name:SWIDERSKA
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 1:9226 GOLF RD
Mailing Address - Street 2:APT. 115
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-1771
Mailing Address - Country:US
Mailing Address - Phone:773-263-8896
Mailing Address - Fax:
Practice Address - Street 1:9226 GOLF RD
Practice Address - Street 2:APT. 115
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-1771
Practice Address - Country:US
Practice Address - Phone:773-263-8896
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-07
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490177091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical