MEDICARE: NINA CORWIN MA 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
1	1041C0700X	Clinical Social Worker	ILSWL149002010	IL

General Provider Information

NPI Number	:	1053415406
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NINA CORWIN MA LCSW

Provider Business Mailing Address
First Line	:	1242 S FEDERAL ST UNIT E
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60605-3389
Country	:	US
Telephone Number	:	312-504-8161
Fax Number	:	312-786-9121

Provider Business Practice Location Address
First Line	:	1242 S FEDERAL ST UNIT E
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60605-3389
Country	:	US
Telephone Number	:	312-504-8161
Fax Number	:	312-786-9121

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/07/2006
Last Update Date	:	06/30/2023

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Directions to “ NINA CORWIN MA LCSW” Practice Location

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