Healthcare Provider Details

I. General information

NPI: 1770134603
Provider Name (Legal Business Name): JANET CHOE-STEAGALL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2019
Last Update Date: 06/02/2023
Certification Date: 06/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2418 W BLOOMINGDALE AVE APT 202
CHICAGO IL
60647-4365
US

IV. Provider business mailing address

2418 W BLOOMINGDALE AVE APT 202
CHICAGO IL
60647-4365
US

V. Phone/Fax

Practice location:
  • Phone: 201-638-7550
  • Fax:
Mailing address:
  • Phone: 201-638-7550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149021687
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number088398
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: