MEDICARE: MRS. JULIA O'CONNOR WRIGHT LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	149015782	IL

General Provider Information

NPI Number	:	1053798926
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JULIA O'CONNOR WRIGHT LCSW

Provider Business Mailing Address
First Line	:	3510 N SPRINGFIELD AVE
Second Line	:	APT 1N
City	:	CHICAGO
State	:	IL
Zip	:	60618-5050
Country	:	US
Telephone Number	:	773-829-2262
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 W BUENA AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60613-6230
Country	:	US
Telephone Number	:	773-665-8052
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/29/2015
Last Update Date	:	04/29/2015

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