Provider Demographics
NPI:1851588461
Name:SANOSHY, ROBERT BENSON (LCSW)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:BENSON
Last Name:SANOSHY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7731 N PAULINA ST APT 3
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626-1062
Mailing Address - Country:US
Mailing Address - Phone:773-991-5321
Mailing Address - Fax:
Practice Address - Street 1:7731 N PAULINA ST APT 3
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60626-1062
Practice Address - Country:US
Practice Address - Phone:773-991-5321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-27
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149-0126241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical