Provider Demographics
NPI:1861539645
Name:SOBIERAJ, KAREN A (MSW LCSW BCD)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:A
Last Name:SOBIERAJ
Suffix:
Gender:F
Credentials:MSW LCSW BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20320 S CRAWFORD
Mailing Address - Street 2:
Mailing Address - City:MATTESON
Mailing Address - State:IL
Mailing Address - Zip Code:60443
Mailing Address - Country:US
Mailing Address - Phone:708-748-6000
Mailing Address - Fax:708-748-6173
Practice Address - Street 1:20320 S CRAWFORD
Practice Address - Street 2:
Practice Address - City:MATTESON
Practice Address - State:IL
Practice Address - Zip Code:60443
Practice Address - Country:US
Practice Address - Phone:708-748-6000
Practice Address - Fax:708-748-6173
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILCERTIFICATE 2774101YA0400X
INN10730751041C0700X
IN340009381041C0700X
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0167110825OtherBLUE CROSS BLUE SHIELD