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General NPI Number Information
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NPI Number | 1518817402
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Entity Type | Individual
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Provider Name | ISAAC KING BSW, RBT
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Gender | Male
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Dates
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Enumeration Date | 01/30/2026
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Last Update Date | 01/30/2026
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Provider Practice Location Address
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Address Line | 105 N OAK PARK AVE FL 2
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City | OAK PARK
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State | IL
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Zip | 60301-1364
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Country | US
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Telephone | 773-423-8447
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Fax |
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Provider Business Mailing Address
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Address Line | 747 E 47TH ST APT 408
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City | CHICAGO
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State | IL
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Zip | 60653-4250
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Country | US
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Telephone | 312-771-9273
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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 | IL
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