MEDICARE: SIERRA HOBSON 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
1	104100000X	Social Worker	150.112388	IL

General Provider Information

NPI Number	:	1295578094
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIERRA HOBSON LSW

Provider Business Mailing Address
First Line	:	39W574 N HYDE PARK
Second Line	:
City	:	GENEVA
State	:	IL
Zip	:	60134-4923
Country	:	US
Telephone Number	:	630-740-3018
Fax Number	:

Provider Business Practice Location Address
First Line	:	8695 ARCHER AVE STE 12
Second Line	:
City	:	WILLOW SPRINGS
State	:	IL
Zip	:	60480-1294
Country	:	US
Telephone Number	:	708-381-0897
Fax Number	:

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

Provider Enumeration Date	:	06/18/2024
Last Update Date	:	06/18/2024

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