Healthcare Provider Details

I. General information

NPI: 1487874012
Provider Name (Legal Business Name): JULIE OSCHERWITZ GRANT L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JULIE GRANT L.C.S.W.

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1083 E LAKE COOK RD
WHEELING IL
60090-2502
US

IV. Provider business mailing address

1083 E LAKE COOK RD
WHEELING IL
60090-2502
US

V. Phone/Fax

Practice location:
  • Phone: 847-650-5313
  • Fax: 847-940-7190
Mailing address:
  • Phone: 847-650-5313
  • Fax: 847-940-7190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: