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NPI Code Detail

MEDICARE: MIKAYLA BAVARO LSW

MEDICARE: MIKAYLA BAVARO LSW
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 Worker

General Provider Information

NPI Number : 1023969888
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIKAYLA BAVARO LSW
Provider Business Mailing Address
First Line : 2030 HASSELL RD APT 214
Second Line :
City : HOFFMAN ESTATES
State : IL
Zip : 60169-6326
Country : US
Telephone Number : 847-340-8111
Fax Number :
Provider Business Practice Location Address
First Line : 377 W VIRGINIA ST
Second Line :
City : CRYSTAL LAKE
State : IL
Zip : 60014-5756
Country : US
Telephone Number : 815-707-4806
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2026
Last Update Date : 02/06/2026

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Directions to “ MIKAYLA BAVARO LSW” Practice Location

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