Undine, Thomas Robert

Undine, Thomas Robert is an individual health care provider with primary practice located at 4958 N Milwaukee Ave , Chicago IL 60630. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / School, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Undine, Thomas Robert can be contacted via phone (773) 207-8500.

Contact Information

Primary practice address
4958 N Milwaukee Ave Chicago IL 60630
Phone: (773) 207-8500
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 1041S0200X 2239902 Illinois
Behavioral Health & Social Service Providers / Clinical 1041C0700X 149.013059 Illinois

Profile Details

NPI number 1245499151
LBN Legal business name Undine, Thomas Robert
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 5th, 2008
Last updated Jul 21st, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Popular Providers