Provider Demographics
NPI:1285046326
Name:MOSCHBERGER, CORI (LCSW)
Entity type:Individual
Prefix:
First Name:CORI
Middle Name:
Last Name:MOSCHBERGER
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 1:2903 SOUTH CT
Mailing Address - Street 2:
Mailing Address - City:ROLLING MEADOWS
Mailing Address - State:IL
Mailing Address - Zip Code:60008-1756
Mailing Address - Country:US
Mailing Address - Phone:847-489-1734
Mailing Address - Fax:
Practice Address - Street 1:290 N RAND RD
Practice Address - Street 2:SUITE D
Practice Address - City:LAKE ZURICH
Practice Address - State:IL
Practice Address - Zip Code:60047-2213
Practice Address - Country:US
Practice Address - Phone:888-261-2178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-23
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0144111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL149.014411OtherDEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION