Provider Demographics
NPI:1730198276
Name:DOLIN, WENDY B (LCSW)
Entity type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:B
Last Name:DOLIN
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 1:180 E PEARSON ST
Mailing Address - Street 2:#5301
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2130
Mailing Address - Country:US
Mailing Address - Phone:312-649-9515
Mailing Address - Fax:
Practice Address - Street 1:2530 CRAWFORD AVE
Practice Address - Street 2:SUITE 219
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-4970
Practice Address - Country:US
Practice Address - Phone:847-251-7350
Practice Address - Fax:847-853-2600
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL886399211104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker