Provider Demographics
NPI:1699580159
Name:WASHINGTON, SIMEON OSCAR (LSW)
Entity type:Individual
Prefix:
First Name:SIMEON
Middle Name:OSCAR
Last Name:WASHINGTON
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 N MICHIGAN AVE STE 2400
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-4040
Mailing Address - Country:US
Mailing Address - Phone:773-609-0361
Mailing Address - Fax:312-896-5595
Practice Address - Street 1:333 N MICHIGAN AVE STE 2400
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-4040
Practice Address - Country:US
Practice Address - Phone:773-609-0361
Practice Address - Fax:312-896-5595
Is Sole Proprietor?:No
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150114133104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker