Provider Demographics
NPI:1588987978
Name:BRONSTEIN, JAIME F (LCSW)
Entity type:Individual
Prefix:MISS
First Name:JAIME
Middle Name:F
Last Name:BRONSTEIN
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 1:440 N WABASH AVE
Mailing Address - Street 2:# 3008
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3549
Mailing Address - Country:US
Mailing Address - Phone:312-909-0318
Mailing Address - Fax:
Practice Address - Street 1:1 E DELAWARE PL
Practice Address - Street 2:STE. #310
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-1449
Practice Address - Country:US
Practice Address - Phone:312-909-0318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-12
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490126441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical