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General NPI Number Information
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NPI Number | 1831238948
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Entity Type | Individual
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Provider Name | ELIOT I WALDMAN LCSW
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Gender | Male
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5225 OLD ORCHARD RD
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City | SKOKIE
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State | IL
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Zip | 60077
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Country | US
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Telephone | 847-256-1113
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Fax | 847-256-8917
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Provider Business Mailing Address
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Address Line | 2841 BIRCHWOOD CT
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City | WILMETTE
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State | IL
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Zip | 60091-2104
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Country | US
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Telephone | 847-256-3888
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Fax | 847-256-8917
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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 |
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License Number State | IL
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