Provider Demographics
NPI:1114815867
Name:VAINTRUB, SONJA (LCSW)
Entity type:Individual
Prefix:
First Name:SONJA
Middle Name:
Last Name:VAINTRUB
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 W ONTARIO ST APT 22I
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-7765
Mailing Address - Country:US
Mailing Address - Phone:773-633-6472
Mailing Address - Fax:
Practice Address - Street 1:333 N MICHIGAN AVE STE 1120
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-4001
Practice Address - Country:US
Practice Address - Phone:773-633-6472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0287521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty