Healthcare Provider Details

I. General information

NPI: 1750158168
Provider Name (Legal Business Name): JANINNA SABIN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2023
Last Update Date: 12/08/2023
Certification Date: 12/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1003 WHITFIELD RD
NORTHBROOK IL
60062-3944
US

IV. Provider business mailing address

1003 WHITFIELD RD
NORTHBROOK IL
60062-3944
US

V. Phone/Fax

Practice location:
  • Phone: 312-859-0250
  • Fax:
Mailing address:
  • Phone: 312-859-0250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number1490516754
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149016754
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number149016754
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: