MEDICARE: MS. MARILYN JOANNE NADULEK 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	149.008999	IL

General Provider Information

NPI Number	:	1144401332
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARILYN JOANNE NADULEK LCSW

Provider Business Mailing Address
First Line	:	2016 N KENNICOTT DR
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-2922
Country	:	US
Telephone Number	:	847-220-1331
Fax Number	:	847-398-3099

Provider Business Practice Location Address
First Line	:	2016 N KENNICOTT DR
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-2922
Country	:	US
Telephone Number	:	847-220-1331
Fax Number	:	847-398-3099

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

Provider Enumeration Date	:	11/16/2007
Last Update Date	:	11/16/2007

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