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NPI Code Detail

MEDICARE: LISA ROBERTS LSW

MEDICARE: LISA ROBERTS LSW
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
1104100000XSocial Worker150112392IL

General Provider Information

NPI Number : 1184561565
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA ROBERTS LSW
Provider Business Mailing Address
First Line : 25 E WASHINGTON ST STE 1835
Second Line :
City : CHICAGO
State : IL
Zip : 60602-1836
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 25 E WASHINGTON ST STE 1835
Second Line :
City : CHICAGO
State : IL
Zip : 60602-1836
Country : US
Telephone Number : 312-940-3655
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2026
Last Update Date : 05/08/2026

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