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NPI Code Detail

MEDICARE: ROBERT J LATIKER LSW

MEDICARE:   ROBERT J LATIKER  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
11041C0700XClinical Social Worker150107880IL

General Provider Information

NPI Number : 1427832112
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT J LATIKER LSW
Provider Business Mailing Address
First Line : 755 ALMAR PKWY STE A
Second Line :
City : BOURBONNAIS
State : IL
Zip : 60914-2393
Country : US
Telephone Number : 789-063-0428
Fax Number :
Provider Business Practice Location Address
First Line : 755 ALMAR PKWY STE A
Second Line :
City : BOURBONNAIS
State : IL
Zip : 60914-2393
Country : US
Telephone Number : 888-428-7890
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2023
Last Update Date : 09/18/2023

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Directions to “ ROBERT J LATIKER LSW” Practice Location

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