MEDICARE: NATHANIEL WHITFIELD 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
1	1041C0700X	Clinical Social Worker	149029259	IL

General Provider Information

NPI Number	:	1457215824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATHANIEL WHITFIELD LCSW

Provider Business Mailing Address
First Line	:	221 N KENILWORTH AVE APT 312
Second Line	:
City	:	OAK PARK
State	:	IL
Zip	:	60302-2051
Country	:	US
Telephone Number	:	847-903-8381
Fax Number	:

Provider Business Practice Location Address
First Line	:	221 N KENILWORTH AVE APT 312
Second Line	:
City	:	OAK PARK
State	:	IL
Zip	:	60302-2051
Country	:	US
Telephone Number	:	847-903-8381
Fax Number	:

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

Provider Enumeration Date	:	12/10/2025
Last Update Date	:	12/10/2025

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