Healthcare Provider Details

I. General information

NPI: 1023932886
Provider Name (Legal Business Name): MACARIOS SVOLOS LSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4433 N RAVENSWOOD AVE STE 210
CHICAGO IL
60640-7755
US

IV. Provider business mailing address

4433 N RAVENSWOOD AVE STE 210
CHICAGO IL
60640-7755
US

V. Phone/Fax

Practice location:
  • Phone: 773-876-8763
  • Fax: 872-315-3138
Mailing address:
  • Phone: 773-876-8763
  • Fax: 872-315-3138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number150130084
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: