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NPI Code Detail

MEDICARE: BETH DLOUHY LCSW

MEDICARE: BETH DLOUHY 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
11041C0700XClinical Social WorkerIL

General Provider Information

NPI Number : 1578105672
Entity Type Code : Individual
Provider Name (Legal Business Name) : BETH DLOUHY LCSW
Provider Business Mailing Address
First Line : 3710 N KEDZIE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60618-4504
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3710 N KEDZIE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60618-4504
Country : US
Telephone Number : 773-564-9070
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2019
Last Update Date : 10/10/2019

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Directions to “ BETH DLOUHY LCSW” Practice Location

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