MEDICARE: MASI A KADZAI 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	TPSW5917	FL
2	1041C0700X	Clinical Social Worker	149.026714	IL

General Provider Information

NPI Number	:	1164279790
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MASI A KADZAI LCSW

Provider Business Mailing Address
First Line	:	1401 W 109TH PL APT 1
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60643-3611
Country	:	US
Telephone Number	:	312-254-6317
Fax Number	:

Provider Business Practice Location Address
First Line	:	1401 W 109TH PL APT 1
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60643-3611
Country	:	US
Telephone Number	:	773-556-4387
Fax Number	:

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

Provider Enumeration Date	:	05/01/2024
Last Update Date	:	04/09/2026

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Directions to “ MASI A KADZAI LCSW” Practice Location

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