Provider Demographics
NPI:1881083673
Name:SCHAUB, JILL C (LCSW)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:C
Last Name:SCHAUB
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17366 OTTAWA AVE
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-3235
Mailing Address - Country:US
Mailing Address - Phone:708-305-6728
Mailing Address - Fax:
Practice Address - Street 1:17366 OTTAWA AVE
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60477-3235
Practice Address - Country:US
Practice Address - Phone:708-305-6728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-15
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0172341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical