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Clinical Social Worker · Chicago, IL

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At a glance

12525 S Eggleston Ave, Chicago, IL 60628-7142

NPPES record updated Aug 15, 2024. Public records can lag behind changes at a practice.

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Practice location

12525 S Eggleston Ave
Chicago, IL 60628-7142

Additional reported practice locations

1524 W 87Th St
Chicago, IL 606204819
Phone: 7739575143
Professional details: NPI, taxonomy & registry record
NPI1629710488
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Registry details

Primary taxonomy
Clinical Social Worker
Taxonomy code
1041C0700X
Enumeration date
Apr 12, 2022
Record updated
Aug 15, 2024
More registry details
Provider type
Organization · Type 2

Reported taxonomies and licenses

Clinical Social Worker

1041C0700X · Primary

Specialty details in registry

251S00000X

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

12525 S Eggleston Ave
Chicago, IL 60628-7142
Phone
(773) 957-5143
Mailing address
12525 S EGGLESTON AVE

CHICAGO, IL 606287142
Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

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