MEDICARE: MRS. ERICKA M WILLIAMS-HAMPTON

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	104100000X	Social Worker
2	1041C0700X	Clinical Social Worker	036-133337	IL

General Provider Information

NPI Number	:	1710188446
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ERICKA M WILLIAMS-HAMPTON

Provider Business Mailing Address
First Line	:	3859 W WEST END AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60624-2356
Country	:	US
Telephone Number	:	773-440-0772
Fax Number	:

Provider Business Practice Location Address
First Line	:	3859 W WEST END AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60624-2356
Country	:	US
Telephone Number	:	773-440-0772
Fax Number	:

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

Provider Enumeration Date	:	05/30/2007
Last Update Date	:	05/04/2021

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