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NPI Code Detail

MEDICARE: SIMONE WOODS LCSW

MEDICARE: SIMONE WOODS 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
11041C0700XClinical Social Worker149019204IL

General Provider Information

NPI Number : 1144728551
Entity Type Code : Individual
Provider Name (Legal Business Name) : SIMONE WOODS LCSW
Provider Business Mailing Address
First Line : 5325 W JACKSON BLVD
Second Line :
City : CHICAGO
State : IL
Zip : 60644-4242
Country : US
Telephone Number : 773-469-3510
Fax Number :
Provider Business Practice Location Address
First Line : 2950 W CHICAGO AVE STE 202
Second Line :
City : CHICAGO
State : IL
Zip : 60622-4377
Country : US
Telephone Number : 773-562-8655
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2018
Last Update Date : 01/31/2018

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Directions to “ SIMONE WOODS LCSW” Practice Location

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