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NPI Code Detail

MEDICARE: KAYLEIGH ARIEL EISENSTEIN LCSW

MEDICARE: KAYLEIGH ARIEL EISENSTEIN 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 Worker149.023224IL

General Provider Information

NPI Number : 1487305439
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLEIGH ARIEL EISENSTEIN LCSW
Provider Business Mailing Address
First Line : 3736 N FREMONT ST APT 1
Second Line :
City : CHICAGO
State : IL
Zip : 60613-5532
Country : US
Telephone Number : 901-277-9695
Fax Number :
Provider Business Practice Location Address
First Line : 6321 N AVONDALE AVE STE 204
Second Line :
City : CHICAGO
State : IL
Zip : 60631-1961
Country : US
Telephone Number : 773-774-4444
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2022
Last Update Date : 01/11/2022

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