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General NPI Number Information
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NPI Number | 1124261060
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Entity Type | Organization
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Legal Business Name | JUSTIN TOBIN. LCSW
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Dates
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Enumeration Date | 04/08/2009
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Last Update Date | 04/09/2009
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Provider Practice Location Address
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Address Line | 180 N MICHIGAN AVE SUITE 916
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City | CHICAGO
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State | IL
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Zip | 60601-7401
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Country | US
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Telephone | 312-346-5156
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Fax | 312-284-6088
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Provider Business Mailing Address
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Address Line | 180 N MICHIGAN AVE SUITE 916
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City | CHICAGO
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State | IL
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Zip | 60601-7401
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Country | US
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Telephone | 312-346-5156
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Fax | 312-284-6088
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Authorized Official
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Title or Position | OWNER
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Name | MR. JUSTIN E TOBIN
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Credential | LCSW
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Telephone | 312-346-5156
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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