MEDICARE: VIRGINIA TRAINOR 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		IL

General Provider Information

NPI Number	:	1659317113
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIRGINIA TRAINOR LCSW

Provider Business Mailing Address
First Line	:	645 W OAK ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60610-7299
Country	:	US
Telephone Number	:	312-925-9629
Fax Number	:

Provider Business Practice Location Address
First Line	:	1406 CHICAGO AVE
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60201-4727
Country	:	US
Telephone Number	:	847-328-6503
Fax Number	:

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

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	07/08/2007

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Directions to “ VIRGINIA TRAINOR LCSW” Practice Location

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