MEDICARE: NIA WELCH

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	104100000X	Social Worker	150115052	IL

General Provider Information

NPI Number	:	1891662441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NIA WELCH

Provider Business Mailing Address
First Line	:	2614 E 73RD ST APT 3
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60649-2702
Country	:	US
Telephone Number	:	872-309-9455
Fax Number	:

Provider Business Practice Location Address
First Line	:	2614 E 73RD ST APT 3
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60649-2702
Country	:	US
Telephone Number	:	872-309-9455
Fax Number	:

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

Provider Enumeration Date	:	10/20/2025
Last Update Date	:	10/20/2025

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Directions to “ NIA WELCH ” Practice Location

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