Healthcare Provider Details

I. General information

NPI: 1093902124
Provider Name (Legal Business Name): JOHN W SYKES JR. LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2007
Last Update Date: 08/12/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 E. 53RD RD SUITE 401
CHICAGO IL
60615-4530
US

IV. Provider business mailing address

7647 S. CLYDE AVENUE
CHICAGO IL
60649-4130
US

V. Phone/Fax

Practice location:
  • Phone: 773-746-0026
  • Fax: 773-966-4469
Mailing address:
  • Phone: 773-746-2317
  • Fax: 773-966-4469

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149009748
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: