MEDICARE: MEREDITH SORELLE HWANG LCSW, MA

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	14901178	IL

General Provider Information

NPI Number	:	1639289606
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEREDITH SORELLE HWANG LCSW, MA

Provider Business Mailing Address
First Line	:	1030 W NEWPORT AVE UNIT 3
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-1504
Country	:	US
Telephone Number	:	773-398-9150
Fax Number	:

Provider Business Practice Location Address
First Line	:	1300 W BELMONT AVE STE 308
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-3241
Country	:	US
Telephone Number	:	773-398-9150
Fax Number	:

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

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	07/08/2007

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