Provider Demographics
NPI:1356234892
Name:GOSS, ANN ELIZABETH (LSW)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:ELIZABETH
Last Name:GOSS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 E SUPERIOR ST STE 5-520
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2914
Mailing Address - Country:US
Mailing Address - Phone:312-695-0990
Mailing Address - Fax:312-503-4800
Practice Address - Street 1:250 E SUPERIOR ST STE 5-520
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2914
Practice Address - Country:US
Practice Address - Phone:312-695-0990
Practice Address - Fax:312-503-4800
Is Sole Proprietor?:No
Enumeration Date:2025-06-02
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150117066104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker