Application For IWCC Attorney Code Number
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Application For IWCC Attorney Code Number Form. This is a Illinois form and can be use in Workers Comp.
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Tags: Application For IWCC Attorney Code Number, Illinois Workers Comp,
ILLINOIS WORKERS' COMPENSATION COMMISSION
100 WEST RANDOLPH STREET #8-200
CHICAGO, IL 60601-3227
312-814-6500
WWW.IWCC.IL.GOV
APPLICATION FOR IWCC ATTORNEY CODE NUMBER
Attorney Firm Name
__________________________________
Address
__________________________________
Suite/P.O. Box
__________________________________
City, State, Zip
__________________________________
E-mail Address
__________________________________
Telephone
__________________________________
Illinois ARDC Registration Number _________________________
RETURN TO: Yvonna Castronova
Public Information Unit
Illinois Workers’ Compensation Commission
100 W. Randolph St. #8-200
Chicago, IL 60601
yvonna.castronova@illinois.gov
Assigned Attorney Code number
_________________________
Date Assigned
_________________________
8/06
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