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NPI Code Detail

MEDICARE: MS. SHARON GANELLEN LCSW

MEDICARE: MS. SHARON GANELLEN 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 Worker149-002587IL

General Provider Information

NPI Number : 1720297484
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SHARON GANELLEN LCSW
Provider Business Mailing Address
First Line : 1011 W WELLINGTON AVE STE 210
Second Line :
City : CHICAGO
State : IL
Zip : 60657-7187
Country : US
Telephone Number : 312-384-1940
Fax Number : 773-423-8444
Provider Business Practice Location Address
First Line : 1011 W WELLINGTON AVE STE 210
Second Line :
City : CHICAGO
State : IL
Zip : 60657-7187
Country : US
Telephone Number : 312-384-1940
Fax Number : 773-423-8444
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2007
Last Update Date : 06/04/2026

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Directions to “ MS. SHARON GANELLEN LCSW” Practice Location

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