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General NPI Number Information
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NPI Number | 1194846915
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Entity Type | Individual
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Provider Name | ISA M SALVADOR LMSW, LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 02/24/2024
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Provider Practice Location Address
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Address Line | 3322 N ASHLAND AVE
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City | CHICAGO
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State | IL
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Zip | 60657
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Country | US
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Telephone | 312-725-0841
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Fax |
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Provider Business Mailing Address
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Address Line | 67 VERNIER RD
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City | GROSSE POINTE SHORES
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State | MI
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Zip | 48236-1516
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Country | US
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Telephone | 313-682-0087
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1194846915
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801085624
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License Number State | MI
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