MEDICARE: HANNAH SOPHIA KOHN SHAKERI 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	104100000X	Social Worker	6801105385	MI
2	1041S0200X	School Social Worker	2444069	IL
3	1041C0700X	Clinical Social Worker	149024173	IL

General Provider Information

NPI Number	:	1326662313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNAH SOPHIA KOHN SHAKERI LCSW

Provider Business Mailing Address
First Line	:	3443 W BARRY AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-6737
Country	:	US
Telephone Number	:	773-236-7219
Fax Number	:

Provider Business Practice Location Address
First Line	:	3443 W BARRY AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-6737
Country	:	US
Telephone Number	:	773-236-7219
Fax Number	:

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

Provider Enumeration Date	:	06/04/2020
Last Update Date	:	04/12/2026

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