Jean Mays, LCSW

Individual provider Active NPI Clinical Social Worker · Broadview, IL

NPI 1336268408 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1336268408
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
149009353 (IL)
Practice address
1820 S 25TH Ave
Broadview, IL 60155-2864
Phone
(708) 338-3806
Fax
(708) 681-1289
NPI assigned
Mar 28, 2007
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)
Yes

State licenses

LicenseStateTypeSpecialty
149009353ILMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149009353 IL Yes

Addresses

Primary practice location

1820 S 25TH Ave
Broadview, IL 60155-2864

Mailing address

1651 N Orchard St Apt 106
Chicago, IL 60614-5398
Phone (708) 338-3806

Other providers in Broadview, IL

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

Sources for this page

Verify at the official NPI Registry.