Healthcare Provider Details

I. General information

NPI: 1356246417
Provider Name (Legal Business Name): CAROLINE OLSEN MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5153 N CLARK ST STE 310
CHICAGO IL
60640-6850
US

IV. Provider business mailing address

1469 W CARMEN AVE APT 1S
CHICAGO IL
60640-2889
US

V. Phone/Fax

Practice location:
  • Phone: 773-234-3212
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: