Provider Demographics
NPI:1821441361
Name:BIBRO, SHARON (LCSW)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:BIBRO
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 1:1310 W CHESTNUT ST
Mailing Address - Street 2:301
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60642-5322
Mailing Address - Country:US
Mailing Address - Phone:312-666-5727
Mailing Address - Fax:
Practice Address - Street 1:1310 W CHESTNUT ST
Practice Address - Street 2:301
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60642-5322
Practice Address - Country:US
Practice Address - Phone:312-666-5727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-20
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0032431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical