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General NPI Number Information
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NPI Number | 1740932300
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Entity Type | Individual
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Provider Name | VARSHA ELIZABETH SIMON LSW
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Gender | Female
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Dates
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Enumeration Date | 01/24/2022
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Last Update Date | 01/24/2022
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Provider Practice Location Address
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Address Line | 405 CENTRAL AVE
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City | NORTHFIELD
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State | IL
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Zip | 60093-3006
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Country | US
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Telephone | 847-441-5600
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Fax |
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Provider Business Mailing Address
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Address Line | 20 NEW ABBEY DR
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City | INVERNESS
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State | IL
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Zip | 60010-6180
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Country | US
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Telephone | 847-767-2521
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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 | 150.106.423
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License Number State | IL
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