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General NPI Number Information
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NPI Number | 1609592633
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Entity Type | Individual
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Provider Name | SABRINA SIMMONS
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Gender | Female
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Dates
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Enumeration Date | 10/12/2022
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Last Update Date | 10/12/2022
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Provider Practice Location Address
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Address Line | 56 E 47TH ST
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City | CHICAGO
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State | IL
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Zip | 60653-3818
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Country | US
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Telephone | 312-577-7285
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Fax |
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Provider Business Mailing Address
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Address Line | 14729 CLIFTON PARK AVE
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City | MIDLOTHIAN
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State | IL
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Zip | 60445-3601
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Country | US
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Telephone | 708-818-8288
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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 | 150.106881
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License Number State | IL
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