Antonise Cox

Individual provider Active NPI Clinical Social Worker · Richton Park, IL

NPI 1417675554 · NPPES record last updated Aug 15, 2022

Key facts

NPI
1417675554
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
149020749 (IL)
Practice address
6279 Oxnard CT
Richton Park, IL 60471-3064
Phone
(773) 263-8834
NPI assigned
Aug 15, 2022
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
149020749ILMDClinical Social Worker
2465288ILMDSchool Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X 2465288 IL
Clinical Social Worker 1041C0700X 149020749 IL Yes

Addresses

Primary practice location

6279 Oxnard CT
Richton Park, IL 60471-3064

Mailing address

6279 Oxnard CT
Richton Park, IL 60471-3064
Phone (773) 263-8834

Other providers in Richton Park, IL

All providers in Richton Park, IL · Clinical Social Worker in Illinois

Sources for this page

Verify at the official NPI Registry.