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NPI Code Detail

MEDICARE: VIOLET GALLARDO LCSW

MEDICARE:   VIOLET  GALLARDO  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 Worker149.025118IL

General Provider Information

NPI Number : 1740143577
Entity Type Code : Individual
Provider Name (Legal Business Name) : VIOLET GALLARDO LCSW
Provider Business Mailing Address
First Line : 111 W JACKSON BLVD STE 1700
Second Line :
City : CHICAGO
State : IL
Zip : 60604-3597
Country : US
Telephone Number : 646-941-7645
Fax Number :
Provider Business Practice Location Address
First Line : 111 W JACKSON BLVD STE 1700
Second Line :
City : CHICAGO
State : IL
Zip : 60604-3597
Country : US
Telephone Number : 646-941-7645
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2025
Last Update Date : 12/08/2025

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Directions to “ VIOLET GALLARDO LCSW” Practice Location

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