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General NPI Number Information
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NPI Number | 1073151247
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Entity Type | Individual
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Provider Name | ERIN B DOPPELT MSW, LSW
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Gender | Female
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Dates
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Enumeration Date | 12/18/2019
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Last Update Date | 02/19/2021
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Provider Practice Location Address
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Address Line | 3048 N MILWAUKEE AVE
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City | CHICAGO
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State | IL
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Zip | 60618-6624
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Country | US
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Telephone | 312-458-9865
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Fax |
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Provider Business Mailing Address
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Address Line | 2631 MULBERRY LN
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City | NORTHBROOK
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State | IL
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Zip | 60062-5936
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Country | US
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Telephone | 847-997-1682
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 150101591
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License Number State | IL
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