Provider Demographics
NPI:1588787279
Name:FERDMAN, CORRI J (LCSW, LLC)
Entity type:Individual
Prefix:MRS
First Name:CORRI
Middle Name:J
Last Name:FERDMAN
Suffix:
Gender:F
Credentials:LCSW, LLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 NORTH SHORE DR
Mailing Address - Street 2:200
Mailing Address - City:LAKE BLUFF
Mailing Address - State:IL
Mailing Address - Zip Code:60044-2243
Mailing Address - Country:US
Mailing Address - Phone:847-793-0788
Mailing Address - Fax:847-793-0789
Practice Address - Street 1:120 W EASTMAN ST
Practice Address - Street 2:301
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-5937
Practice Address - Country:US
Practice Address - Phone:847-793-0788
Practice Address - Fax:847-793-0789
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490097591041C0700X
IL23620101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL200866811OtherCORPHEALTH
IL200866811OtherFIRST HEALTH
IL200866811OtherUNITED HEALTH CARE
IL200866811OtherVALUE OPTIONS
IL200866811OtherUNITED BEHAVIORAL HEALTH
IL200866811OtherAETNA
IL200866811OtherHUMANA
IL200866811OtherCIGNA
IL493-2415OtherBLUE CROSS BLUE SHIELD
IL793339000OtherMAGELLAN
IL200866811OtherLIFE SYNCH
IL200866811OtherPHCS