MEDICARE: AMELIA LAMBERT

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	149018933	IL

General Provider Information

NPI Number	:	1568904068
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMELIA LAMBERT

Provider Business Mailing Address
First Line	:	7023 WILLOW SPRINGS RD APT 201
Second Line	:
City	:	COUNTRYSIDE
State	:	IL
Zip	:	60525-4842
Country	:	US
Telephone Number	:	630-240-2721
Fax Number	:

Provider Business Practice Location Address
First Line	:	7023 WILLOW SPRINGS RD APT 201
Second Line	:
City	:	COUNTRYSIDE
State	:	IL
Zip	:	60525-4842
Country	:	US
Telephone Number	:	630-240-2721
Fax Number	:

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

Provider Enumeration Date	:	11/15/2016
Last Update Date	:	11/15/2016

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Directions to “ AMELIA LAMBERT ” Practice Location

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