MEDICARE: MR. BRADLEY SCHWARTZ L.C.S.W

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
2	1041C0700X	Clinical Social Worker	149.016218	IL

General Provider Information

NPI Number	:	1396160990
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BRADLEY SCHWARTZ L.C.S.W

Provider Business Mailing Address
First Line	:	4728 N PAULINA ST APT 3N3
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-4431
Country	:	US
Telephone Number	:	312-330-6387
Fax Number	:

Provider Business Practice Location Address
First Line	:	2634 N. FAIRFIELD AVE.,
Second Line	:	#2
City	:	CHICAGO
State	:	IL
Zip	:	60647
Country	:	US
Telephone Number	:	312-330-6387
Fax Number	:

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

Provider Enumeration Date	:	02/19/2014
Last Update Date	:	07/21/2025

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