MEDICARE: MILLA LUBIS LCSW PLLC

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

General Provider Information

NPI Number	:	1851192231
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MILLA LUBIS LCSW PLLC

Provider Business Mailing Address
First Line	:	6516 S MINERVA AVE APT 2N
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60637-4397
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6516 S MINERVA AVE APT 2N
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60637-4397
Country	:	US
Telephone Number	:	630-708-8945
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MILLA LUBIS
Credential	:	LCSW
Telephone Number	:	630-708-8945

Provider Enumeration Date	:	03/21/2025
Last Update Date	:	03/21/2025

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