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NPI Code Detail

MEDICARE: AMY GILROY LCSW, QMHP

MEDICARE: AMY GILROY LCSW, QMHP
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 Worker149.031681IL

General Provider Information

NPI Number : 1174900153
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY GILROY LCSW, QMHP
Provider Business Mailing Address
First Line : 325 IL ROUTE 2
Second Line :
City : DIXON
State : IL
Zip : 61021-9118
Country : US
Telephone Number : 815-440-5754
Fax Number : 815-718-6589
Provider Business Practice Location Address
First Line : 1321 N 7TH ST
Second Line :
City : ROCHELLE
State : IL
Zip : 61068-1185
Country : US
Telephone Number : 815-562-3801
Fax Number : 815-562-4481
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/29/2015
Last Update Date : 04/10/2026

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