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NPI Code Detail

MEDICARE: MISS LINDSAY BANMAN

MEDICARE: MISS LINDSAY BANMAN
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 Worker

General Provider Information

NPI Number : 1386770618
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS LINDSAY BANMAN
Provider Business Mailing Address
First Line : 3600 W FULLERTON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60647-2319
Country : US
Telephone Number : 773-782-5015
Fax Number :
Provider Business Practice Location Address
First Line : 3600 W FULLERTON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60647-2319
Country : US
Telephone Number : 773-782-5015
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2007
Last Update Date : 07/08/2007

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Directions to “ MISS LINDSAY BANMAN ” Practice Location

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