MEDICARE: SANDRA MANLEY-EICHLER 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	149.018246	IL

General Provider Information

NPI Number	:	1487289914
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA MANLEY-EICHLER LCSW

Provider Business Mailing Address
First Line	:	2007 95TH ST STE 105
Second Line	:
City	:	NAPERVILLE
State	:	IL
Zip	:	60564-7802
Country	:	US
Telephone Number	:	630-646-6920
Fax Number	:

Provider Business Practice Location Address
First Line	:	2007 95TH ST STE 105
Second Line	:
City	:	NAPERVILLE
State	:	IL
Zip	:	60564-7802
Country	:	US
Telephone Number	:	630-646-6920
Fax Number	:

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

Provider Enumeration Date	:	03/04/2020
Last Update Date	:	04/13/2021

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