MEDICARE: BRIANNA ZIELKE 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	149041068	IL

General Provider Information

NPI Number	:	1609693746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIANNA ZIELKE LCSW

Provider Business Mailing Address
First Line	:	2735 HASSERT BLVD # 135-301
Second Line	:
City	:	NAPERVILLE
State	:	IL
Zip	:	60564-5204
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1502 W CHICAGO AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60642-5236
Country	:	US
Telephone Number	:	312-339-8604
Fax Number	:

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

Provider Enumeration Date	:	09/20/2024
Last Update Date	:	03/23/2026

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