MEDICARE: MS. BESSIE SULTON AKUAMOAH MSW

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	1041C0700X	Clinical Social Worker	149.008286	IL
2	1041S0200X	School Social Worker	149.008286	IL

General Provider Information

NPI Number	:	1730213299
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BESSIE SULTON AKUAMOAH MSW

Provider Business Mailing Address
First Line	:	1145 E HYDE PARK BLVD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60615-2834
Country	:	US
Telephone Number	:	773-370-7687
Fax Number	:	773-363-0448

Provider Business Practice Location Address
First Line	:	1145 E HYDE PARK BLVD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60615-2834
Country	:	US
Telephone Number	:	773-370-7687
Fax Number	:	773-363-0448

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

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	01/05/2016

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