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NPI Code Detail

MEDICARE: CECELIA S CORNELL LCSW

MEDICARE:   CECELIA S CORNELL  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 Worker149.008739IL

General Provider Information

NPI Number : 1497994354
Entity Type Code : Individual
Provider Name (Legal Business Name) : CECELIA S CORNELL LCSW
Provider Business Mailing Address
First Line : 5053 N MERRIMAC AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60630-1832
Country : US
Telephone Number : 312-550-8707
Fax Number :
Provider Business Practice Location Address
First Line : 5053 N MERRIMAC AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60630-1832
Country : US
Telephone Number : 312-550-8707
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2009
Last Update Date : 11/13/2025

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Directions to “ CECELIA S CORNELL LCSW” Practice Location

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