MEDICARE: MISS ALANA MICHELLE BURKE 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	149028723	IL

General Provider Information

NPI Number	:	1710790357
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS ALANA MICHELLE BURKE LCSW

Provider Business Mailing Address
First Line	:	3414 N ELAINE PL APT 3W
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-9045
Country	:	US
Telephone Number	:	224-688-6393
Fax Number	:

Provider Business Practice Location Address
First Line	:	3414 N ELAINE PL APT 3W
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-9045
Country	:	US
Telephone Number	:	224-688-6393
Fax Number	:

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

Provider Enumeration Date	:	01/28/2025
Last Update Date	:	01/28/2025

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