Sophia A Register, LCSW

Individual provider Active NPI Clinical Social Worker · Hines, IL

NPI 1073785481 · NPPES record last updated Mar 31, 2008

Key facts

NPI
1073785481
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
Practice address
5000 S 5TH Ave
Hines, IL 60141-3030
Phone
(708) 202-5563
NPI assigned
Mar 25, 2008
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
149.012831ILMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X IL Yes

Addresses

Primary practice location

5000 S 5TH Ave
Hines, IL 60141-3030

Mailing address

5000 S 5TH Ave
Hines, IL 60141-3030
Phone (708) 202-5563

Other providers in Hines, IL

All providers in Hines, IL · Clinical Social Worker in Illinois

Sources for this page

Verify at the official NPI Registry.