Provider Demographics
NPI:1730249970
Name:NEUBERGER, JOEL ISSAC (MSSW)
Entity type:Individual
Prefix:MR
First Name:JOEL
Middle Name:ISSAC
Last Name:NEUBERGER
Suffix:
Gender:M
Credentials:MSSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 BEACON CT
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-4104
Mailing Address - Country:US
Mailing Address - Phone:847-890-8890
Mailing Address - Fax:
Practice Address - Street 1:3759 N RAVENSWOOD AVE
Practice Address - Street 2:SUITE 133
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-3571
Practice Address - Country:US
Practice Address - Phone:847-890-8890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490039811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical