Healthcare Provider Details

I. General information

NPI: 1932949278
Provider Name (Legal Business Name): GENESIS ALEJANDRA GARCIA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2024
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 E OGDEN AVE STE 304
WESTMONT IL
60559-5554
US

IV. Provider business mailing address

700 E OGDEN AVE STE 304
WESTMONT IL
60559-5554
US

V. Phone/Fax

Practice location:
  • Phone: 847-232-4535
  • Fax: 847-230-7626
Mailing address:
  • Phone: 847-232-4535
  • Fax: 847-230-7626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.027200
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: