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General NPI Number Information
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NPI Number | 1790927770
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Entity Type | Organization
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Legal Business Name | MONICA K. FERKIN, LLC
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Dates
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Enumeration Date | 04/06/2009
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Last Update Date | 10/26/2015
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Provider Practice Location Address
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Address Line | 1800 NATIONS DR
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City | GURNEE
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State | IL
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Zip | 60031-9168
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Country | US
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Telephone | 224-501-5102
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Fax |
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Provider Business Mailing Address
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Address Line | 7285 CLEM DR
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City | GURNEE
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State | IL
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Zip | 60031-5194
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | MONICA K. FERKIN
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Credential | LCSW, CADC, CEAP
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Telephone | 847-770-7202
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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 | 6617-123
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149.000023
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License Number State | IL
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