MEDICARE: MS. ISABEL ANN SNYDER 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	104100000X	Social Worker	149-002835	IL

General Provider Information

NPI Number	:	1063652790
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ISABEL ANN SNYDER LCSW

Provider Business Mailing Address
First Line	:	9039 WEST 23RD ST.
Second Line	:
City	:	NORTH RIVERSIDE
State	:	IL
Zip	:	60546
Country	:	US
Telephone Number	:	708-443-5035
Fax Number	:

Provider Business Practice Location Address
First Line	:	9039 WEST 23RD ST.
Second Line	:
City	:	NORTH RIVERSIDE
State	:	IL
Zip	:	60546
Country	:	US
Telephone Number	:	708-443-5035
Fax Number	:

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

Provider Enumeration Date	:	02/20/2009
Last Update Date	:	02/20/2009

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