MEDICARE: DORI GINGER BOWLING 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
1	1041C0700X	Clinical Social Worker	149.012944	IL

General Provider Information

NPI Number	:	1285919266
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DORI GINGER BOWLING L.C.S.W.

Provider Business Mailing Address
First Line	:	7037 S HARPER AVE
Second Line	:	1A
City	:	CHICAGO
State	:	IL
Zip	:	60637-4872
Country	:	US
Telephone Number	:	773-620-9275
Fax Number	:

Provider Business Practice Location Address
First Line	:	7037 S HARPER AVE
Second Line	:	1A
City	:	CHICAGO
State	:	IL
Zip	:	60637-4872
Country	:	US
Telephone Number	:	773-620-9275
Fax Number	:

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

Provider Enumeration Date	:	10/20/2011
Last Update Date	:	02/15/2012

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Directions to “ DORI GINGER BOWLING L.C.S.W.” Practice Location

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