Provider Demographics
NPI:1386085892
Name:BAXTER STESHETZ, DEVON (LCSW)
Entity type:Individual
Prefix:
First Name:DEVON
Middle Name:
Last Name:BAXTER STESHETZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DEVON
Other - Middle Name:
Other - Last Name:BAXTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1319 DOBSON ST
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-3715
Mailing Address - Country:US
Mailing Address - Phone:773-930-8075
Mailing Address - Fax:
Practice Address - Street 1:1535 ELLINWOOD AVE
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-4553
Practice Address - Country:US
Practice Address - Phone:773-570-3337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-12
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0160361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical