MEDICARE: ANNE POLER 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	149.016009	IL
2	1041C0700X	Clinical Social Worker	09924961	CO

General Provider Information

NPI Number	:	1093131906
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNE POLER LCSW

Provider Business Mailing Address
First Line	:	31 PARK LANE
Second Line	:
City	:	GOLF
State	:	IL
Zip	:	60029
Country	:	US
Telephone Number	:	773-727-2643
Fax Number	:

Provider Business Practice Location Address
First Line	:	1634 N ROCKWELL ST
Second Line	:	1
City	:	CHICAGO
State	:	IL
Zip	:	60647-5218
Country	:	US
Telephone Number	:	773-727-2643
Fax Number	:

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

Provider Enumeration Date	:	03/16/2014
Last Update Date	:	08/28/2017

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Directions to “ ANNE POLER LCSW” Practice Location

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