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NPI Code Detail

MEDICARE: JULIE MANN

MEDICARE: JULIE MANN
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 Worker150.111789IL

General Provider Information

NPI Number : 1588354823
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIE MANN
Provider Business Mailing Address
First Line : 210 AVENUE C
Second Line :
City : DANVILLE
State : IL
Zip : 61832-5410
Country : US
Telephone Number :
Fax Number : 210-443-0378
Provider Business Practice Location Address
First Line : 210 AVENUE C
Second Line :
City : DANVILLE
State : IL
Zip : 61832-5410
Country : US
Telephone Number : 217-442-3200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2023
Last Update Date : 04/22/2026

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Directions to “ JULIE MANN ” Practice Location

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