MEDICARE: LORRAINE CHANDRAMA LAHORI 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	149031544	IL

General Provider Information

NPI Number	:	1811674682
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORRAINE CHANDRAMA LAHORI LCSW

Provider Business Mailing Address
First Line	:	4945 W WOLFRAM ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60641-5143
Country	:	US
Telephone Number	:	773-472-6469
Fax Number	:	773-661-0911

Provider Business Practice Location Address
First Line	:	3656 N HALSTED ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60613-5974
Country	:	US
Telephone Number	:	774-472-6469
Fax Number	:

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

Provider Enumeration Date	:	07/03/2023
Last Update Date	:	04/07/2026

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