Provider Demographics
NPI:1649624370
Name:CHAPMAN, JUDITH (CADC)
Entity type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1909 CHEKER SQ
Mailing Address - Street 2:
Mailing Address - City:EAST HAZEL CREST
Mailing Address - State:IL
Mailing Address - Zip Code:60429-1442
Mailing Address - Country:US
Mailing Address - Phone:708-647-3393
Mailing Address - Fax:708-647-3503
Practice Address - Street 1:1909 CHEKER SQ
Practice Address - Street 2:
Practice Address - City:EAST HAZEL CREST
Practice Address - State:IL
Practice Address - Zip Code:60429-1442
Practice Address - Country:US
Practice Address - Phone:708-647-3393
Practice Address - Fax:708-647-3503
Is Sole Proprietor?:No
Enumeration Date:2016-04-19
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL16964101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL16964OtherCADC,