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NPI Code Detail

MEDICARE: DANIELLE MARINO L.C.S.W.

MEDICARE: DANIELLE MARINO L.C.S.W.
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
11041C0700XClinical Social Worker149.014697IL

General Provider Information

NPI Number : 1154686822
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELLE MARINO L.C.S.W.
Provider Business Mailing Address
First Line : 2441 N KEDZIE BLVD
Second Line : SUITE 1
City : CHICAGO
State : IL
Zip : 60647-2674
Country : US
Telephone Number : 773-662-8088
Fax Number :
Provider Business Practice Location Address
First Line : 2441 N KEDZIE BLVD
Second Line : SUITE 1
City : CHICAGO
State : IL
Zip : 60647-2674
Country : US
Telephone Number : 773-662-8088
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2012
Last Update Date : 03/28/2025

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