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General NPI Number Information
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NPI Number | 1225845373
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Entity Type | Individual
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Provider Name | JAMIE KAREN MANEWITH MSW, LSW
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Gender | Female
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Dates
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Enumeration Date | 12/12/2024
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Last Update Date | 12/23/2024
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Provider Practice Location Address
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Address Line | 799 CENTRAL AVE
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City | HIGHLAND PARK
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State | IL
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Zip | 60035-5637
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Country | US
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Telephone | 224-998-4766
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Fax |
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Provider Business Mailing Address
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Address Line | 1308 ARBOR VITAE RD
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City | DEERFIELD
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State | IL
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Zip | 60015-2875
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Country | US
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Telephone | 847-951-2064
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 150114695
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License Number State | IL
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