is a Clinical in Chicago, Illinois. practices all healthcare services and medical treatments related to Clinical. The NPI Number for is 1235180829. The last update date is .
's current location address is 1501 S California Ave, Chicago, Illinois. You can contact this provider via phone number 7732576770. The mailing address for is 1501 S California Ave, Chicago, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 1501 S California Ave, Chicago, Illinois |
| Phone Number | 7732576770 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1235180829 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 1501 S California Ave |
|---|---|
| City | Chicago |
| State | Illinois (IL) |
| Post Code | 606081732 |
| Phone Number | 7732576770 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 149-010818 |
|
Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 149-010818 | IL | STATE LICENSE |
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