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
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Illinois ARDC Registration Number _________________________ RETURN TO: Yvonna Castronova Public Information Unit Illinois Workers' Compensation Commission 100 W. Randolph St. #8-200 Chicago, IL 60601 [email protected] Assigned Attorney Code number Date Assigned _________________________ _________________________
8/06