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NPI Code Detail

MEDICARE: JESSICA ELIZABETH BYCHAWSKI LCSW

MEDICARE: JESSICA ELIZABETH BYCHAWSKI LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker149020196IL

General Provider Information

NPI Number : 1013044957
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA ELIZABETH BYCHAWSKI LCSW
Provider Business Mailing Address
First Line : 5472 S ELLIS AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60615-5059
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5472 S ELLIS AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60615-5059
Country : US
Telephone Number : 925-525-1498
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2007
Last Update Date : 05/14/2026

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