MEDICARE: ANTHONY P. OLTEAN L.C.S.W., C.A.D.C.

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	149.013104	IL

General Provider Information

NPI Number	:	1689962151
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY P. OLTEAN L.C.S.W., C.A.D.C.

Provider Business Mailing Address
First Line	:	918 W MARGATE TER # 3E
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-3810
Country	:	US
Telephone Number	:	773-620-2023
Fax Number	:

Provider Business Practice Location Address
First Line	:	5412 N CLARK ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-1223
Country	:	US
Telephone Number	:	773-620-2023
Fax Number	:

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

Provider Enumeration Date	:	07/18/2011
Last Update Date	:	07/18/2011

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