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NPI Code Detail

MEDICARE: MADELINE I BRIGELL LCSW

MEDICARE: MADELINE I BRIGELL 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
11041C0700XClinical Social Worker149015240IL
21041C0700XClinical Social Worker

General Provider Information

NPI Number : 1215240437
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADELINE I BRIGELL LCSW
Provider Business Mailing Address
First Line : 1623 N WESTERN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60647-5321
Country : US
Telephone Number : 773-803-8707
Fax Number :
Provider Business Practice Location Address
First Line : 1623 N WESTERN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60647-5321
Country : US
Telephone Number : 773-803-8707
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2010
Last Update Date : 07/24/2024

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Directions to “ MADELINE I BRIGELL LCSW” Practice Location

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