Healthcare Provider Details

I. General information

NPI: 1205968658
Provider Name (Legal Business Name): KAREN M. VROMAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 03/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 E 53RD ST SUITE 516-11-1
CHICAGO IL
60615-4557
US

IV. Provider business mailing address

5141 S HARPER AVE # 1
CHICAGO IL
60615-4119
US

V. Phone/Fax

Practice location:
  • Phone: 773-490-2531
  • Fax: 773-363-7390
Mailing address:
  • Phone: 773-490-2531
  • Fax: 773-363-7390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.012319
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: