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NPI 1811872096

NPI 1811872096 : SHELLY SELLA SACHS LCSW : CHICAGO, IL

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General NPI Number Information
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    NPI Number           |    1811872096
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    Entity Type          |    Individual 
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    Provider Name        |    SHELLY SELLA SACHS LCSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/07/2025
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    Last Update Date     |    08/07/2025
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Provider Practice Location Address
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    Address Line         |    1150 N LAKE SHORE DR APT 7F 
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    City                 |    CHICAGO
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    State                |    IL
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    Zip                  |    60611-5220
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    Country              |    US
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    Telephone            |    847-962-5332
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1150 N LAKE SHORE DR APT 7F 
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    City                 |    CHICAGO
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    State                |    IL
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    Zip                  |    60611-5220
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    Country              |    US
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    Telephone            |    
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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       |    149.010844
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    License Number State |    IL
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