Healthcare Provider Details

I. General information

NPI: 1699749416
Provider Name (Legal Business Name): ISENBERG AND ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2006
Last Update Date: 10/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

236 S WASHINGTON ST SUITE 200
NAPERVILLE IL
60540-5371
US

IV. Provider business mailing address

236 S WASHINGTON ST SUITE 200
NAPERVILLE IL
60540-5371
US

V. Phone/Fax

Practice location:
  • Phone: 630-355-8410
  • Fax: 630-355-8412
Mailing address:
  • Phone: 630-355-8410
  • Fax: 630-355-8412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149000660
License Number StateIL

VIII. Authorized Official

Name: MR. JEFFREY LARSON
Title or Position: OWNER
Credential: LCSW
Phone: 630-355-8410