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NPI 1619094489

NPI 1619094489 : ROBERT MICHAEL ADAMS LCSW : LOMBARD, IL

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General NPI Number Information
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    NPI Number           |    1619094489
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    Entity Type          |    Individual 
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    Provider Name        |    ROBERT MICHAEL ADAMS LCSW
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/24/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    450 E 22ND ST SUITE 220
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    City                 |    LOMBARD
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    State                |    IL
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    Zip                  |    60148-6113
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    Country              |    US
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    Telephone            |    630-916-8401
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    Fax                  |    630-916-9931
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Provider Business Mailing Address
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    Address Line         |    450 E 22ND ST SUITE 220
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    City                 |    LOMBARD
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    State                |    IL
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    Zip                  |    60148-6113
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    Country              |    US
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    Telephone            |    630-916-8401
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    Fax                  |    630-916-9931
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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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