Mark Steven Samuelson in Evanston - Clinical

Mark Steven Samuelson - NPI 1740322502

Mark Steven Samuelson is a Clinical in Evanston, Illinois. Mark Steven Samuelson practices all healthcare services and medical treatments related to Clinical. The NPI Number for Mark Steven Samuelson is 1740322502. The last update date is 2008-06-02.

Mark Steven Samuelson's current location address is 2550 Crawford Avenue, Evanston, Illinois. You can contact this provider via phone number 8474759500 and fax number 3127828276. The mailing address for Mark Steven Samuelson is 2550 Crawford Avenue, Evanston, Illinois. To know further, please read the information below!

Provider Profile Detail

Provider Name Mark Steven Samuelson
Address 2550 Crawford Avenue, Evanston, Illinois
Phone Number 8474759500
Fax Number 3127828276
Sole Proprietor Y
Credentials L.C.S.W.

NPI Number Detail

NPI Number 1740322502
Provider Enumeration Date 2007-02-12
Last Updated Date 2008-06-02

Provider Mailing Address Detail

Address 2550 Crawford Avenue
City Evanston
State Illinois (IL)
Post Code 602014983
Phone Number 8474759500
Fax Number 3127828276

Provider's Primary Taxonomy Detail

Speciality Clinical
Taxonomy 1041C0700X
Licence No 149000936
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

Provider's Other Legacy Identifiers

Identifier Identifier Type Identifier State Identifier Issuer
016-71240 IL BLUE CROSS OF ILLINOIS
348588200 IL DEPT. OF LABOR OWCP

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FAQs about Mark Steven Samuelson

What is the unique identification code assigned to Mark Steven Samuelson by the Centers for Medicare & Medicaid Services?

The Mark Steven Samuelson has been issued the NPI (National Provider Identifier) 1740322502. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).

Could you please provide the complete street address where Mark Steven Samuelson is physically located?

The Mark Steven Samuelson is physically situated at the following address: 2550 Crawford Avenue, Evanston, IL, 602014983.

What is Mark Steven Samuelson's area of expertise and its corresponding taxonomy classification?

The Mark Steven Samuelson's field of specialization is Clinical, and it falls under the taxonomy code 1041C0700X, which categorizes healthcare providers based on their areas of practice.

On what date did the Mark Steven Samuelson receive the assignment of its 1740322502 from the Centers for Medicare & Medicaid Services?

The Mark Steven Samuelson was issued its 1740322502 by the Centers for Medicare & Medicaid Services on 2007-02-12.

When was the information pertaining to Mark Steven Samuelson most recently updated or revised?

The details related to Mark Steven Samuelson, including its address, specialty, and other relevant information, were last updated or revised on 2008-06-02.

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