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General NPI Number Information
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NPI Number | 1245987593
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Entity Type | Individual
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Provider Name | PARIS SIMONE HEARON LSW
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Gender | Female
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Dates
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Enumeration Date | 03/07/2022
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Last Update Date | 03/07/2022
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Provider Practice Location Address
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Address Line | 700 N SACRAMENTO BLVD STE 201
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City | CHICAGO
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State | IL
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Zip | 60612-1058
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Country | US
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Telephone | 224-213-1577
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Fax |
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Provider Business Mailing Address
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Address Line | 17757 PAXTON AVE
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City | LANSING
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State | IL
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Zip | 60438-1572
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Country | US
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Telephone | 708-351-6918
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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 | 150.105518
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License Number State | IL
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