Provider Demographics
NPI:1336250869
Name:EISENBERG, ROBIN P (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:P
Last Name:EISENBERG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:P
Other - Last Name:EISENBERG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:2201 LAKESIDE DR
Mailing Address - Street 2:
Mailing Address - City:BANNOCKBURN
Mailing Address - State:IL
Mailing Address - Zip Code:60015-1265
Mailing Address - Country:US
Mailing Address - Phone:847-502-5400
Mailing Address - Fax:
Practice Address - Street 1:2201 LAKESIDE DR
Practice Address - Street 2:
Practice Address - City:BANNOCKBURN
Practice Address - State:IL
Practice Address - Zip Code:60015-1265
Practice Address - Country:US
Practice Address - Phone:847-502-5400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490047891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical