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NPI Code Detail

MEDICARE: MELANIE C. GEYER LCSW

MEDICARE: MELANIE C. GEYER 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 Worker149-007645IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1149-007645OTHERILBCBS

General Provider Information

NPI Number : 1356363394
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELANIE C. GEYER LCSW
Provider Business Mailing Address
First Line : 4740 N CLARK ST
Second Line :
City : CHICAGO
State : IL
Zip : 60640-4689
Country : US
Telephone Number : 773-769-0205
Fax Number :
Provider Business Practice Location Address
First Line : 4740 N CLARK ST
Second Line :
City : CHICAGO
State : IL
Zip : 60640-4689
Country : US
Telephone Number : 773-769-0205
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2006
Last Update Date : 12/04/2007

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