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General NPI Number Information
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NPI Number | 1407057581
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Entity Type | Individual
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Provider Name | MELANIE AMIN LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/29/2007
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Last Update Date | 10/19/2021
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Provider Practice Location Address
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Address Line | 15 TOWER CT STE 300
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City | GURNEE
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State | IL
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Zip | 60031-3346
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Country | US
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Telephone | 847-599-3600
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Fax | 847-599-8897
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Provider Business Mailing Address
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Address Line | 2650 RIDGE AVE STE 1223
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City | EVANSTON
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State | IL
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Zip | 60201-1700
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Country | US
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Telephone | 847-982-6715
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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 | 149008147
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License Number State | IL
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