MEDICARE: MS. BARBARA J. COLLINSON-PAUTZ 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
1	1041C0700X	Clinical Social Worker	149001650	IL

General Provider Information

NPI Number	:	1689752057
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BARBARA J. COLLINSON-PAUTZ LCSW

Provider Business Mailing Address
First Line	:	125 S WILKE RD
Second Line	:	SUITE 200A
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-1534
Country	:	US
Telephone Number	:	847-870-0771
Fax Number	:	857-870-0770

Provider Business Practice Location Address
First Line	:	125 S WILKE RD
Second Line	:	SUITE 200A
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-1534
Country	:	US
Telephone Number	:	847-870-0771
Fax Number	:	857-870-0770

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	04/28/2008

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