MEDICARE: ANN FISHER RANEY 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		IL

General Provider Information

NPI Number	:	1538118476
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANN FISHER RANEY LCSW

Provider Business Mailing Address
First Line	:	1032 HULL TER
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60202-3311
Country	:	US
Telephone Number	:	847-869-9149
Fax Number	:

Provider Business Practice Location Address
First Line	:	1525 E 53RD ST
Second Line	:	SUITE 719
City	:	CHICAGO
State	:	IL
Zip	:	60615-4557
Country	:	US
Telephone Number	:	847-869-9158
Fax Number	:

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

Provider Enumeration Date	:	05/09/2006
Last Update Date	:	07/08/2007

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Directions to “ ANN FISHER RANEY LCSW” Practice Location

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