Provider Demographics
NPI:1285919266
Name:BOWLING, DORI GINGER (LCSW)
Entity type:Individual
Prefix:
First Name:DORI
Middle Name:GINGER
Last Name:BOWLING
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:DORI
Other - Middle Name:GINGER
Other - Last Name:WALTERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7037 S HARPER AVE
Mailing Address - Street 2:1A
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60637-4872
Mailing Address - Country:US
Mailing Address - Phone:773-620-9275
Mailing Address - Fax:
Practice Address - Street 1:7037 S HARPER AVE
Practice Address - Street 2:1A
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-4872
Practice Address - Country:US
Practice Address - Phone:773-620-9275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-20
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0129441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical