Provider Demographics
NPI:1356730576
Name:CORSO, JOHN B (LCSW)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:B
Last Name:CORSO
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1515 PHEASANT TRAIL LN
Mailing Address - Street 2:APT 6
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004
Mailing Address - Country:US
Mailing Address - Phone:847-903-2369
Mailing Address - Fax:
Practice Address - Street 1:6201 W CERMAK RD
Practice Address - Street 2:2ND FLOOR/ LOMBARD ENTRANCE
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402-2331
Practice Address - Country:US
Practice Address - Phone:708-788-8808
Practice Address - Fax:708-788-8549
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-12
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149-0122481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical