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NPI Code Detail

MEDICARE: JESSICA CAMPBELL LSW

MEDICARE: JESSICA CAMPBELL 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 Worker150.115222IL

General Provider Information

NPI Number : 1073462636
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA CAMPBELL LSW
Provider Business Mailing Address
First Line : 1438 W BELMONT AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60657-2150
Country : US
Telephone Number : 312-508-3645
Fax Number :
Provider Business Practice Location Address
First Line : 1438 W BELMONT AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60657-2150
Country : US
Telephone Number : 312-508-3645
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2026
Last Update Date : 01/27/2026

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Directions to “ JESSICA CAMPBELL LSW” Practice Location

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