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NPI Code Detail

MEDICARE: CLARE COLETTE THOELE MSW, LSW

MEDICARE: CLARE COLETTE THOELE MSW, 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 Worker150105490IL

General Provider Information

NPI Number : 1053078717
Entity Type Code : Individual
Provider Name (Legal Business Name) : CLARE COLETTE THOELE MSW, LSW
Provider Business Mailing Address
First Line : 355 E ERIE ST
Second Line :
City : CHICAGO
State : IL
Zip : 60611-3167
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 303 E WACKER DR STE 1130
Second Line :
City : CHICAGO
State : IL
Zip : 60601-5227
Country : US
Telephone Number : 312-934-7701
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2021
Last Update Date : 02/19/2025

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