Provider Demographics
NPI:1669723284
Name:GORMAN, CORNELIUS FRANCIS III (LCSW)
Entity type:Individual
Prefix:MR
First Name:CORNELIUS
Middle Name:FRANCIS
Last Name:GORMAN
Suffix:III
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 1:1125 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-3551
Mailing Address - Country:US
Mailing Address - Phone:630-247-1978
Mailing Address - Fax:
Practice Address - Street 1:1125 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-3551
Practice Address - Country:US
Practice Address - Phone:630-247-1978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-21
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0154601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical