Provider Demographics
NPI:1578310231
Name:COBB, STEFANIE (MSW)
Entity type:Individual
Prefix:MRS
First Name:STEFANIE
Middle Name:
Last Name:COBB
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 N ORLEANS ST STE 350
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-3145
Mailing Address - Country:US
Mailing Address - Phone:312-809-0298
Mailing Address - Fax:866-687-0879
Practice Address - Street 1:820 N ORLEANS ST STE 350
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610-3145
Practice Address - Country:US
Practice Address - Phone:312-809-0298
Practice Address - Fax:866-687-0879
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-01
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILPENDING104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker