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NPI Code Detail

MEDICARE: MICHAEL GRANZOW

MEDICARE: MICHAEL GRANZOW
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 Worker150.119005IL

General Provider Information

NPI Number : 1538012893
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL GRANZOW
Provider Business Mailing Address
First Line : 5800 N SHERIDAN RD APT 504
Second Line :
City : CHICAGO
State : IL
Zip : 60660-4931
Country : US
Telephone Number : 301-613-4317
Fax Number :
Provider Business Practice Location Address
First Line : 5800 N SHERIDAN RD APT 504
Second Line :
City : CHICAGO
State : IL
Zip : 60660-4931
Country : US
Telephone Number : 301-613-4317
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/17/2026
Last Update Date : 02/17/2026

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Directions to “ MICHAEL GRANZOW ” Practice Location

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