Carla Amato-Martz

Individual provider Active NPI Clinical Social Worker · Glen Ellyn, IL

NPI 1104338441 · NPPES record last updated Oct 26, 2017

Key facts

NPI
1104338441
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
149-006275 (IL)
Practice address
947 Oxford Rd
Glen Ellyn, IL 60137-4813
Phone
(773) 459-7272
NPI assigned
Oct 26, 2017
Sex
Female
Sole proprietor
Yes

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
149-006275ILMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149-006275 IL Yes

Addresses

Primary practice location

947 Oxford Rd
Glen Ellyn, IL 60137-4813

Mailing address

947 Oxford Rd
Glen Ellyn, IL 60137-4813
Phone (773) 459-7272

Other providers in Glen Ellyn, IL

All providers in Glen Ellyn, IL · Clinical Social Worker in Illinois

Sources for this page

Verify at the official NPI Registry.