MEDICARE: MRS. JOANNA MARIA CZYZ MSW, 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	150109874	IL

General Provider Information

NPI Number	:	1366018871
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JOANNA MARIA CZYZ MSW, LSW

Provider Business Mailing Address
First Line	:	2325 DEAN ST STE 500
Second Line	:
City	:	ST CHARLES
State	:	IL
Zip	:	60175-4803
Country	:	US
Telephone Number	:	331-257-5868
Fax Number	:

Provider Business Practice Location Address
First Line	:	2325 DEAN ST STE 500
Second Line	:
City	:	SAINT CHARLES
State	:	IL
Zip	:	60175-4803
Country	:	US
Telephone Number	:	331-257-5868
Fax Number	:

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

Provider Enumeration Date	:	06/03/2021
Last Update Date	:	11/19/2024

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