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NPI Code Detail

MEDICARE: TREASURED LIFE THERAPEUTIC SVC SC

MEDICARE: TREASURED LIFE THERAPEUTIC SVC SC
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
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1104532134
Entity Type Code : Organization
Provider Name (Legal Business Name) : TREASURED LIFE THERAPEUTIC SVC SC
Provider Business Mailing Address
First Line : 401 N MICHIGAN AVE STE 1200
Second Line :
City : CHICAGO
State : IL
Zip : 60611-4264
Country : US
Telephone Number : 312-798-9212
Fax Number : 844-246-6796
Provider Business Practice Location Address
First Line : 401 N MICHIGAN AVE STE 1200
Second Line :
City : CHICAGO
State : IL
Zip : 60611-4264
Country : US
Telephone Number : 312-798-9212
Fax Number : 844-246-6796
Authorized Official
Title or Position : LCSW
Name : SHANA JACKSON
Credential : LCSW
Telephone Number : 312-752-7892
Provider Enumeration Date : 01/24/2023
Last Update Date : 01/12/2026

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Directions to “TREASURED LIFE THERAPEUTIC SVC SC ” Practice Location

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