Provider Demographics
NPI:1962717744
Name:WANDLER, SHERYL ANN (LCSW)
Entity type:Individual
Prefix:MS
First Name:SHERYL
Middle Name:ANN
Last Name:WANDLER
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 1:722 W BRIAR PL
Mailing Address - Street 2:UNIT 3
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-4515
Mailing Address - Country:US
Mailing Address - Phone:773-294-1834
Mailing Address - Fax:
Practice Address - Street 1:722 W BRIAR PL
Practice Address - Street 2:UNIT 3
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-4515
Practice Address - Country:US
Practice Address - Phone:773-294-1834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-17
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0084741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical