Healthcare Provider Details

I. General information

NPI: 1073142642
Provider Name (Legal Business Name): MELISSA ANNE SVEC MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2020
Last Update Date: 07/26/2023
Certification Date: 02/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451 N LA SALLE DR
CHICAGO IL
60654-4510
US

IV. Provider business mailing address

10633 S HARDING AVE
CHICAGO IL
60655-3825
US

V. Phone/Fax

Practice location:
  • Phone: 312-755-2250
  • Fax:
Mailing address:
  • Phone: 773-620-5601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number150104265
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149025004
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: