Healthcare Provider Details

I. General information

NPI: 1154244119
Provider Name (Legal Business Name): ALESSANDRA ADORA GRANT LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2043 W BELMONT AVE
CHICAGO IL
60618-6795
US

IV. Provider business mailing address

1142 W MADISON ST STE 302
CHICAGO IL
60607-2191
US

V. Phone/Fax

Practice location:
  • Phone: 312-248-6825
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number150.129878
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: