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NPI Code Detail

MEDICARE: MR. MATTHEW ADAM SILVER LCSW

MEDICARE: MR. MATTHEW ADAM SILVER 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
1101YA0400XAddiction (Substance Use Disorder) Counselor25641IL
21041C0700XClinical Social Worker149.018234IL

General Provider Information

NPI Number : 1780042788
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MATTHEW ADAM SILVER LCSW
Provider Business Mailing Address
First Line : 1958 W WINONA ST
Second Line :
City : CHICAGO
State : IL
Zip : 60640-2661
Country : US
Telephone Number : 773-350-2462
Fax Number :
Provider Business Practice Location Address
First Line : 992 1/2 GREEN BAY RD
Second Line :
City : WINNETKA
State : IL
Zip : 60093-1722
Country : US
Telephone Number : 847-446-8060
Fax Number : 847-446-9768
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/04/2016
Last Update Date : 02/04/2016

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