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General NPI Number Information
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NPI Number | 1699343459
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Entity Type | Individual
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Provider Name | CASSANDRA JEAN GREENWALD LSW
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Gender | Female
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Dates
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Enumeration Date | 06/16/2021
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Last Update Date | 06/16/2021
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Provider Practice Location Address
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Address Line | 122 S MICHIGAN AVE STE 1433
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City | CHICAGO
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State | IL
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Zip | 60603-6169
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Country | US
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Telephone | 847-529-8300
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Fax |
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Provider Business Mailing Address
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Address Line | 5957 N GLENWOOD AVE APT 3
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City | CHICAGO
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State | IL
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Zip | 60660-4192
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Country | US
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Telephone | 773-414-5336
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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 | 150105215
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License Number State | IL
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