Provider Demographics
NPI:1750603247
Name:WEISBLATT, ANNE M (LCSW)
Entity type:Individual
Prefix:MS
First Name:ANNE
Middle Name:M
Last Name:WEISBLATT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:M
Other - Last Name:MARAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:306 LASALLE ST
Mailing Address - Street 2:
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-4144
Mailing Address - Country:US
Mailing Address - Phone:630-254-2067
Mailing Address - Fax:
Practice Address - Street 1:655 ROCKLAND RD
Practice Address - Street 2:SUITE 207
Practice Address - City:LAKE BLUFF
Practice Address - State:IL
Practice Address - Zip Code:60044-1782
Practice Address - Country:US
Practice Address - Phone:630-254-2067
Practice Address - Fax:630-254-2067
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-24
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490070071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical