Provider Demographics
NPI:1184951667
Name:VERDONE, SALVATORE (LCSW)
Entity type:Individual
Prefix:MR
First Name:SALVATORE
Middle Name:
Last Name:VERDONE
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 1:555 TOLLGATE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-9314
Mailing Address - Country:US
Mailing Address - Phone:847-742-0413
Mailing Address - Fax:847-742-1393
Practice Address - Street 1:555 TOLLGATE RD
Practice Address - Street 2:SUITE A
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-9314
Practice Address - Country:US
Practice Address - Phone:847-742-0413
Practice Address - Fax:847-742-1393
Is Sole Proprietor?:No
Enumeration Date:2009-11-04
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490057501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical