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NPI Code Detail

MEDICARE: ISKRA THERAPY & CONSULTING LLC

MEDICARE: ISKRA THERAPY & CONSULTING LLC
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 Worker

General Provider Information

NPI Number : 1538986310
Entity Type Code : Organization
Provider Name (Legal Business Name) : ISKRA THERAPY & CONSULTING LLC
Provider Business Mailing Address
First Line : 5521 S EVERETT AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60637-1956
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5521 S EVERETT AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60637-1956
Country : US
Telephone Number : 312-399-5815
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : DR. ANNETTE ISKRA
Credential : LCSW
Telephone Number : 312-399-5815
Provider Enumeration Date : 09/24/2024
Last Update Date : 11/08/2024

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Directions to “ISKRA THERAPY & CONSULTING LLC ” Practice Location

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