Provider Demographics
NPI:1912047416
Name:CHAPMAN, JUDITH LESLIE (LCSW)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:LESLIE
Last Name:CHAPMAN
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 1:333 N MICHIGAN AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-3901
Mailing Address - Country:US
Mailing Address - Phone:312-977-9099
Mailing Address - Fax:312-977-5004
Practice Address - Street 1:333 N MICHIGAN AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-3901
Practice Address - Country:US
Practice Address - Phone:312-977-9099
Practice Address - Fax:312-977-5004
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical