Provider Demographics
NPI:1538179429
Name:GERBER, ANITA S (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ANITA
Middle Name:S
Last Name:GERBER
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 1:1111 13TH ST
Mailing Address - Street 2:
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091-1627
Mailing Address - Country:US
Mailing Address - Phone:847-251-5189
Mailing Address - Fax:847-251-5189
Practice Address - Street 1:1111 13TH ST
Practice Address - Street 2:
Practice Address - City:WILMETTE
Practice Address - State:IL
Practice Address - Zip Code:60091-1627
Practice Address - Country:US
Practice Address - Phone:847-707-5189
Practice Address - Fax:847-251-5189
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2015-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490016651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL596780Medicare PIN