Provider Demographics
NPI:1871003897
Name:SHABANA, KARIMA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KARIMA
Middle Name:
Last Name:SHABANA
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 1:2848 N SHEFFIELD AVE APT 2S
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-7010
Mailing Address - Country:US
Mailing Address - Phone:312-610-9030
Mailing Address - Fax:
Practice Address - Street 1:2625 BUTTERFIELD RD STE 101N
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-3405
Practice Address - Country:US
Practice Address - Phone:630-586-0900
Practice Address - Fax:630-586-9990
Is Sole Proprietor?:No
Enumeration Date:2017-10-04
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL22871141041S0200X
IL149.0190701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool