MEDICARE: DEBORAH M AIMONE 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	149007887	IL

General Provider Information

NPI Number	:	1306595210
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH M AIMONE LCSW

Provider Business Mailing Address
First Line	:	1813 WAVERLY WAY
Second Line	:
City	:	MONTGOMERY
State	:	IL
Zip	:	60538-4133
Country	:	US
Telephone Number	:	630-618-6943
Fax Number	:

Provider Business Practice Location Address
First Line	:	1813 WAVERLY WAY
Second Line	:
City	:	MONTGOMERY
State	:	IL
Zip	:	60538-4133
Country	:	US
Telephone Number	:	630-618-6943
Fax Number	:

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

Provider Enumeration Date	:	03/20/2022
Last Update Date	:	03/20/2022

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