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NPI Code Detail

MEDICARE: RESILIENT ROOTS THERAPY GROUP PLLC

MEDICARE: RESILIENT ROOTS THERAPY GROUP 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
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1982551636
Entity Type Code : Organization
Provider Name (Legal Business Name) : RESILIENT ROOTS THERAPY GROUP PLLC
Provider Business Mailing Address
First Line : 3838 W 111TH ST STE 107
Second Line :
City : CHICAGO
State : IL
Zip : 60655-4028
Country : US
Telephone Number : 773-270-0443
Fax Number :
Provider Business Practice Location Address
First Line : 3838 W 111TH ST STE 107
Second Line :
City : CHICAGO
State : IL
Zip : 60655-4028
Country : US
Telephone Number : 773-270-0443
Fax Number :
Authorized Official
Title or Position : OWNER/THERAPIST
Name : LIZBETH MONTES
Credential : LCSW
Telephone Number : 708-469-9726
Provider Enumeration Date : 03/12/2026
Last Update Date : 03/12/2026

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Directions to “RESILIENT ROOTS THERAPY GROUP PLLC ” Practice Location

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