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NPI Code Detail

MEDICARE: JACQUELINE KING-PAPADOPOULOS LCSW

MEDICARE:   JACQUELINE  KING-PAPADOPOULOS  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
1104100000XSocial Worker149028136IL

General Provider Information

NPI Number : 1013642008
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELINE KING-PAPADOPOULOS LCSW
Provider Business Mailing Address
First Line : 3817 N BERNARD ST
Second Line :
City : CHICAGO
State : IL
Zip : 60618-3243
Country : US
Telephone Number : 773-616-5456
Fax Number :
Provider Business Practice Location Address
First Line : 3054 N CLIFTON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60657-4334
Country : US
Telephone Number : 773-616-5456
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2022
Last Update Date : 04/28/2026

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Directions to “ JACQUELINE KING-PAPADOPOULOS LCSW” Practice Location

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