Provider Demographics
NPI:1891020921
Name:COOK, JULIE MICHELLE (MSW)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:MICHELLE
Last Name:COOK
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 993
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-0993
Mailing Address - Country:US
Mailing Address - Phone:630-651-4377
Mailing Address - Fax:630-260-0867
Practice Address - Street 1:1N307 RICHARD AVE
Practice Address - Street 2:
Practice Address - City:CAROL STREAM
Practice Address - State:IL
Practice Address - Zip Code:60188-2217
Practice Address - Country:US
Practice Address - Phone:630-651-4377
Practice Address - Fax:630-260-0867
Is Sole Proprietor?:No
Enumeration Date:2009-10-07
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490096651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical