MEDICARE: MRS. SONDRA MONET TAYLOR MSW, L.C.S.W.

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	149019823	IL
2	171M00000X	Case Manager/Care Coordinator	898634	IL

General Provider Information

NPI Number	:	1982038568
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SONDRA MONET TAYLOR MSW, L.C.S.W.

Provider Business Mailing Address
First Line	:	9938 S CAMPBELL AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60655-1063
Country	:	US
Telephone Number	:	773-574-8794
Fax Number	:

Provider Business Practice Location Address
First Line	:	5113 S HARPER AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60615-4119
Country	:	US
Telephone Number	:	773-574-8794
Fax Number	:

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

Provider Enumeration Date	:	08/30/2013
Last Update Date	:	06/30/2020

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