Basic Information
| Provider Information | |||||||||
| NPI: | 1417251380 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ASHUM | ||||||||
| FirstName: | ANNA | ||||||||
| MiddleName: | N | ||||||||
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| Credential: | MSW, LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15419 E 127TH ST | ||||||||
| Address2: | |||||||||
| City: | LEMONT | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604396494 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6307777113 | ||||||||
| FaxNumber: | 6302430317 | ||||||||
| Practice Location | |||||||||
| Address1: | 15419 E 127TH ST | ||||||||
| Address2: | |||||||||
| City: | LEMONT | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604396494 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6307777113 | ||||||||
| FaxNumber: | 6302430317 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/06/2011 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 149012665 | IL | N | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041C0700X | 149018883 | IL | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.