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General NPI Number Information
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NPI Number | 1366992216
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Entity Type | Individual
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Provider Name | BRIAN MACWILLIAMS LCSW
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Gender | Male
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Dates
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Enumeration Date | 10/04/2016
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Last Update Date | 06/21/2023
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Provider Practice Location Address
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Address Line | 1604 CHICAGO AVE STE 8
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City | EVANSTON
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State | IL
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Zip | 60201-6017
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Country | US
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Telephone | 312-298-9355
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Fax |
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Provider Business Mailing Address
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Address Line | 6446 N SHERIDAN RD # 511
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City | CHICAGO
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State | IL
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Zip | 60626-5336
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Country | US
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Telephone |
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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 |
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License Number State |
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