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NPI Code Detail

MEDICARE: SHAYSA ESTHER VILLA LCSW

MEDICARE: SHAYSA ESTHER VILLA 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 Worker149021207IL

General Provider Information

NPI Number : 1417511890
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAYSA ESTHER VILLA LCSW
Provider Business Mailing Address
First Line : 1136 S DELANO CT W STE B201
Second Line :
City : CHICAGO
State : IL
Zip : 60605-3734
Country : US
Telephone Number : 312-667-3884
Fax Number :
Provider Business Practice Location Address
First Line : 47 W POLK ST STE 325
Second Line :
City : CHICAGO
State : IL
Zip : 60605-2175
Country : US
Telephone Number : 312-667-3884
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/30/2019
Last Update Date : 05/14/2025

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Directions to “ SHAYSA ESTHER VILLA LCSW” Practice Location

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