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NPI Code Detail

MEDICARE: THOMAS BASS MSW LCSW

MEDICARE: THOMAS BASS MSW 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 WorkerIL

General Provider Information

NPI Number : 1699850859
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS BASS MSW LCSW
Provider Business Mailing Address
First Line : 992 1/2 GREEN BAY RD
Second Line :
City : WINNETKA
State : IL
Zip : 60093-1722
Country : US
Telephone Number : 847-446-8060
Fax Number : 847-446-9768
Provider Business Practice Location Address
First Line : 992 1/2 GREEN BAY RD
Second Line :
City : WINNETKA
State : IL
Zip : 60093-1722
Country : US
Telephone Number : 847-446-8060
Fax Number : 847-446-9768
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2006
Last Update Date : 07/08/2007

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Directions to “ THOMAS BASS MSW LCSW” Practice Location

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