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NPI Code Detail

MEDICARE: MRS. GUADALUPE MAYA-VESKOVIC LCSW

MEDICARE: MRS. GUADALUPE MAYA-VESKOVIC 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
11041C0700XClinical Social Worker149019850IL

General Provider Information

NPI Number : 1669986915
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. GUADALUPE MAYA-VESKOVIC LCSW
Provider Business Mailing Address
First Line : 30 W MONROE ST
Second Line :
City : CHICAGO
State : IL
Zip : 60603-2495
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 30 W MONROE ST STE 1200
Second Line :
City : CHICAGO
State : IL
Zip : 60603-2420
Country : US
Telephone Number : 773-609-1758
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/24/2017
Last Update Date : 01/23/2018

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