Jeremy Brook Hisaw is a Clinical in Chicago, Illinois. Jeremy Brook Hisaw practices all healthcare services and medical treatments related to Clinical. The NPI Number for Jeremy Brook Hisaw is 1083701429. The last update date is 2007-07-08.
Jeremy Brook Hisaw's current location address is 1733 W Crystal St, Chicago, Illinois. You can contact this provider via phone number 7734030473. The mailing address for Jeremy Brook Hisaw is 1733 W Crystal St, Chicago, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jeremy Brook Hisaw |
|---|---|
| Address | 1733 W Crystal St, Chicago, Illinois |
| Phone Number | 7734030473 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | LCSW |
NPI Number Detail
| NPI Number | 1083701429 |
|---|---|
| Provider Enumeration Date | 2006-10-06 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 1733 W Crystal St |
|---|---|
| City | Chicago |
| State | Illinois (IL) |
| Post Code | 606228801 |
| Phone Number | 7734030473 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
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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 |
|---|---|---|---|
| 1636404 | IL | BC/BS PROVIDER NUMBER |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Jeremy Brook Hisaw by the Centers for Medicare & Medicaid Services?
The Jeremy Brook Hisaw has been issued the NPI (National Provider Identifier) 1083701429 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please share the complete physical location address where Jeremy Brook Hisaw's facilities are situated?
The facilities of Jeremy Brook Hisaw are physically located at the following address: 1733 W Crystal St, Chicago, IL, 606228801.
What is Jeremy Brook Hisaw's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Jeremy Brook Hisaw is Clinical, and the taxonomy code that classifies this field of practice is 1041C0700X.
On what date did the Centers for Medicare & Medicaid Services issue the 1083701429 to Jeremy Brook Hisaw?
The Jeremy Brook Hisaw received its 1083701429 assignment from the Centers for Medicare & Medicaid Services on 2006-10-06.
As of what date were the details pertaining to Jeremy Brook Hisaw last refreshed?
The information related to the Jeremy Brook Hisaw, including its address, specialty, and other relevant details, was last updated on 2007-07-08.