7739956300
Organization Active NPI Clinical Social Worker · Chicago, IL
NPI 1336685494 · NPPES record last updated Jan 13, 2017
Key facts
- NPI
- 1336685494
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 149018713 (IL)
- Legal business name
- 7739956300
- Practice address
- 1029 E 130TH St
Chicago, IL 60628-6908 - Phone
- (773) 995-6300
- Fax
- (773) 995-6192
- NPI assigned
- Jan 13, 2017
- Organization subpart
- No
Authorized official
- Name
- Ms. Marquetta D Hall, CPCS
- Title
- Billing Coding Specialist
- Phone
- (773) 995-6300
Practitioners 1
National Provider Directory
Locations
1029 E 130th St
Chicago, IL 60628
Phone (773) 995-6300
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker |
1041C0700X | 149018713 | IL | Yes |
Addresses
Primary practice location
1029 E 130TH St
Chicago, IL 60628-6908
Mailing address
1029 E.130TH Street
Chicago, IL 60628
Phone (773) 995-6300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 149018713 | Other | IL | 149018713 |
Other names
- TCA HEALTH CARE
Other providers in Chicago, IL
- 7011 W Archer Ave
- 7140 Dorchester Properties LLC
- 71St and Exchange Opco LLC
- 7400 Western Inc
- 7645 Will Care LLC
- 7TH Heaven Private Home Care LLC
- 7TH Stone Wellness
- 87TH Street Rehab Clinic LLC
- 888 Orthodontics, PC
- 900 Pharmacy LLC
All providers in Chicago, IL · Clinical Social Worker in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 13, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.