Thomas Alan Plach, LCSW
Individual provider Active NPI Clinical Social Worker · Broadview, IL
NPI 1457578965 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1457578965
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- Practice address
- 1820 S 25TH Ave
Broadview, IL 60155-2864 - Phone
- (708) 338-3806
- Fax
- (708) 681-9496
- NPI assigned
- Apr 19, 2007
- Sex
- Male
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 149.003503 | IL | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | IL | Yes |
Addresses
Primary practice location
1820 S 25TH Ave
Broadview, IL 60155-2864
Mailing address
1820 S 25TH Ave
Broadview, IL 60155-2864
Phone (708) 338-3806
Other providers in Broadview, IL
- Pathways to Intentional Therapy and Consulting LLC
- Patricia M Moser OD PC
- Genoveva Perez
- Kenita J. Perry-Bell
- David Phan
- Britteny Poe
- Avery Polizzi
- Prakash K. Upadhyaya DDS LTD.
- Presence Behavioral Health
- Presence Behavioral Health
All providers in Broadview, 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 Jul 8, 2007. 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.