Provider Demographics
NPI:1013245729
Name:FORSTER, ERIC G (LCSW)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:G
Last Name:FORSTER
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 1:6101 S. COUNTY LINE ROAD
Mailing Address - Street 2:KING-BRUWAERT HOUSE
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-8132
Mailing Address - Country:US
Mailing Address - Phone:630-230-9527
Mailing Address - Fax:
Practice Address - Street 1:6101 S COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:BURR RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60527-8132
Practice Address - Country:US
Practice Address - Phone:630-230-9527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-19
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490132311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical