Provider Demographics
NPI:1750366811
Name:REINERSMAN, JANICE D (LCSW)
Entity type:Individual
Prefix:MS
First Name:JANICE
Middle Name:D
Last Name:REINERSMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:JANICE
Other - Middle Name:DIEHL
Other - Last Name:REINERSMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:53 WEST JACKSON BOULEVARD
Mailing Address - Street 2:SUITE 1336
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60604
Mailing Address - Country:US
Mailing Address - Phone:312-362-9401
Mailing Address - Fax:
Practice Address - Street 1:1807 HICKS RD
Practice Address - Street 2:SUITE D
Practice Address - City:ROLLING MEADOWS
Practice Address - State:IL
Practice Address - Zip Code:60008-1242
Practice Address - Country:US
Practice Address - Phone:312-362-9401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-13
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490045071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL001605919OtherBLUE CROSS BLUE SHIELD
IL207677Medicare PIN