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NPI Code Detail

MEDICARE: MARGE ELLEN EPSTEIN

MEDICARE: MARGE ELLEN EPSTEIN
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

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10001636159OTHERILBLUE CROSS/BLUE SHIELD PP

General Provider Information

NPI Number : 1619081809
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARGE ELLEN EPSTEIN
Provider Business Mailing Address
First Line : 1111 WESTGATE ST
Second Line :
City : OAK PARK
State : IL
Zip : 60301-1007
Country : US
Telephone Number : 708-848-0576
Fax Number :
Provider Business Practice Location Address
First Line : 1111 WESTGATE ST
Second Line :
City : OAK PARK
State : IL
Zip : 60301-1007
Country : US
Telephone Number : 708-848-0576
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2006
Last Update Date : 07/08/2007

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Directions to “ MARGE ELLEN EPSTEIN ” Practice Location

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