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General NPI Number Information
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NPI Number | 1780863142
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Entity Type | Organization
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Legal Business Name | NANCY SMITH L.C.S.W.,P.C.
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Dates
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Enumeration Date | 11/01/2007
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Last Update Date | 01/16/2008
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Provider Practice Location Address
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Address Line | 4753 N BROADWAY ST #928
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City | CHICAGO
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State | IL
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Zip | 60640-5266
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Country | US
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Telephone | 773-878-8440
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Fax |
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Provider Business Mailing Address
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Address Line | 4753 N BROADWAY ST #928
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City | CHICAGO
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State | IL
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Zip | 60640-5266
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Country | US
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Telephone | 773-878-8440
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | MS. NANCY SMITH
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Credential |
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Telephone | 773-878-8440
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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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