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General NPI Number Information
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NPI Number | 1235681974
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Entity Type | Organization
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Legal Business Name | ANNE TUMBORELLO AND ASSOCIATES
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Dates
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Enumeration Date | 10/28/2016
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Last Update Date | 10/28/2016
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Provider Practice Location Address
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Address Line | 2200 S. MAIN STREET SUITE 303
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City | LOMBARD
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State | IL
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Zip | 60148
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Country | US
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Telephone | 630-504-0705
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Fax |
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Provider Business Mailing Address
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Address Line | 2200 S MAIN ST STE 303
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City | LOMBARD
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State | IL
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Zip | 60148-5366
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Country | US
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Telephone | 630-504-0705
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | ANNE TUMBORELLO
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Credential | LCSW CADC
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Telephone | 630-504-0705
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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 | 149.015527
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License Number State | IL
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