Provider Demographics
NPI:1720258742
Name:SONNEBORN, JULIA WICK (MSW LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:WICK
Last Name:SONNEBORN
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1327 EVERGREEN CT.
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025
Mailing Address - Country:US
Mailing Address - Phone:847-486-8584
Mailing Address - Fax:847-276-2762
Practice Address - Street 1:459 CENTRAL AVE.
Practice Address - Street 2:SUITE 100
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60034
Practice Address - Country:US
Practice Address - Phone:847-998-0915
Practice Address - Fax:847-276-2762
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-05
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490063241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical