MEDICARE: UPSTREAM HEALTH LLC

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

General Provider Information

NPI Number	:	1760299168
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UPSTREAM HEALTH LLC

Provider Business Mailing Address
First Line	:	903 N HONORE ST APT 1
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60622-5791
Country	:	US
Telephone Number	:	847-337-9442
Fax Number	:

Provider Business Practice Location Address
First Line	:	903 N HONORE ST APT 1
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60622-5791
Country	:	US
Telephone Number	:	847-920-8554
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SHANA SANCHEZ
Credential	:	LCSW
Telephone Number	:	847-337-9442

Provider Enumeration Date	:	12/18/2024
Last Update Date	:	04/28/2026

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Directions to “UPSTREAM HEALTH LLC ” Practice Location

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