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NPI Code Detail

MEDICARE: SOPHIA JELSMA

MEDICARE: SOPHIA JELSMA
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 Worker149.027418IL

General Provider Information

NPI Number : 1487172425
Entity Type Code : Individual
Provider Name (Legal Business Name) : SOPHIA JELSMA
Provider Business Mailing Address
First Line : 213 W INSTITUTE PL STE 500
Second Line :
City : CHICAGO
State : IL
Zip : 60610-8792
Country : US
Telephone Number : 312-285-0740
Fax Number :
Provider Business Practice Location Address
First Line : 213 W INSTITUTE PL STE 500
Second Line :
City : CHICAGO
State : IL
Zip : 60610-8792
Country : US
Telephone Number : 312-285-0740
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2017
Last Update Date : 02/16/2026

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Directions to “ SOPHIA JELSMA ” Practice Location

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