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NPI Code Detail

MEDICARE: MS. SARA ANN LINDSTROM LCSW

MEDICARE: MS. SARA ANN LINDSTROM 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
11041C0700XClinical Social WorkerIL

General Provider Information

NPI Number : 1982626933
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SARA ANN LINDSTROM LCSW
Provider Business Mailing Address
First Line : 2042 W FARRAGUT AVE
Second Line : APT 3S
City : CHICAGO
State : IL
Zip : 60625-1270
Country : US
Telephone Number : 773-365-3060
Fax Number : 773-365-3091
Provider Business Practice Location Address
First Line : 4740 N CLARK ST
Second Line :
City : CHICAGO
State : IL
Zip : 60640-4689
Country : US
Telephone Number : 773-769-0205
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2006
Last Update Date : 07/08/2007

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