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NPI 1639887847

NPI 1639887847 : PORCIA SEALS : CHICAGO, IL

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General NPI Number Information
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    NPI Number           |    1639887847
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    Entity Type          |    Individual 
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    Provider Name        |    PORCIA SEALS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/08/2022
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    Last Update Date     |    12/09/2025
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Provider Practice Location Address
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    Address Line         |    875 N MICHIGAN AVE FL 31 
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    City                 |    CHICAGO
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    State                |    IL
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    Zip                  |    60611-1962
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    Country              |    US
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    Telephone            |    312-868-5493
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2512 S SENOUR AVE 
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    City                 |    CHICAGO
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    State                |    IL
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    Zip                  |    60608-5724
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    Country              |    US
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    Telephone            |    312-868-5493
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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       |    LW61504440
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    License Number State |    WA
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Taxonomy #2
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    149018804
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    License Number State |    IL
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Taxonomy #3
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    12756-C
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    License Number State |    NV
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