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NPI Code Detail

MEDICARE: MRS. REBECCA ANNE GADOMSKI LSW, LCSW

MEDICARE: MRS. REBECCA ANNE GADOMSKI LSW, 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 Worker149011718IL

General Provider Information

NPI Number : 1255455838
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. REBECCA ANNE GADOMSKI LSW, LCSW
Provider Business Mailing Address
First Line : 8S744 WAYEWOOD LN
Second Line :
City : NAPERVILLE
State : IL
Zip : 60565-9232
Country : US
Telephone Number : 630-873-9052
Fax Number : 630-428-7891
Provider Business Practice Location Address
First Line : 2948 ARTESIAN RD STE 112
Second Line :
City : NAPERVILLE
State : IL
Zip : 60564-8559
Country : US
Telephone Number : 630-428-7890
Fax Number : 630-428-7891
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2007
Last Update Date : 01/15/2023

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