MEDICARE: AUDREY FALZONE LSW, MSW

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	104100000X	Social Worker
2	104100000X	Social Worker	150111265	IL
3	1041C0700X	Clinical Social Worker	149.031014	IL

General Provider Information

NPI Number	:	1225706229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUDREY FALZONE LSW, MSW

Provider Business Mailing Address
First Line	:	617 W CORNELIA AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-8557
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1440 W TAYLOR ST UNIT 1078
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60607-4623
Country	:	US
Telephone Number	:	872-216-1757
Fax Number	:

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

Provider Enumeration Date	:	09/02/2021
Last Update Date	:	04/20/2026

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