Cindy Chabolla, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.017474 Issued in IL

Practice address

2542 W North Ave
Chicago, IL 60647-5216

Phone

(773) 365-7277

NPI assigned

Apr 2, 2015

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1427932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427932800000",
    "number": "1063807378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2542 W NORTH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606475216",
            "telephone_number": "773-365-7277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2542 W NORTH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606475216",
            "telephone_number": "773-365-7277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHABOLLA",
        "first_name": "CINDY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-02",
        "last_updated": "2015-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.017474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donald Cha, DDS
• Esther Cha
• Rosaline Eunbee Cha, O.D.
• Archit Aravind Chabbi
• Alesa Chabbra, MD
• Chace Wall Psychotherapy, LLC
• Anoop Chacko Achanaril, MBBS
• Emily Chacko, M.D.
• Jupin Chacko
• Mary J Chacko

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.