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NPI Code Detail

MEDICARE: MS. JOYCE KAY WEBER SR. L.C.S.W.

MEDICARE: MS. JOYCE KAY WEBER SR. L.C.S.W.
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 WorkerIL

General Provider Information

NPI Number : 1215023031
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JOYCE KAY WEBER SR. L.C.S.W.
Provider Business Mailing Address
First Line : 4110 N CENTRAL PARK AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60618-2018
Country : US
Telephone Number : 773-267-3510
Fax Number :
Provider Business Practice Location Address
First Line : 3249 N CENTRAL AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60634-4360
Country : US
Telephone Number : 773-371-3700
Fax Number : 773-282-6698
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2006
Last Update Date : 07/08/2007

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