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NPI Code Detail

MEDICARE: MS. MICHELLE M TAYLOR LCSW

MEDICARE: MS. MICHELLE M TAYLOR 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
1104100000XSocial Worker149008358IL

General Provider Information

NPI Number : 1700482908
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MICHELLE M TAYLOR LCSW
Provider Business Mailing Address
First Line : 1371 E 50TH ST APT 3
Second Line :
City : CHICAGO
State : IL
Zip : 60615-2940
Country : US
Telephone Number : 773-456-4945
Fax Number :
Provider Business Practice Location Address
First Line : 5841 S MARYLAND AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60637-1443
Country : US
Telephone Number : 888-824-0200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2020
Last Update Date : 02/02/2026

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