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NPI Code Detail

MEDICARE: NAOMI WACHS

MEDICARE: NAOMI WACHS
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 Worker149.022290IL

General Provider Information

NPI Number : 1770056350
Entity Type Code : Individual
Provider Name (Legal Business Name) : NAOMI WACHS
Provider Business Mailing Address
First Line : PO BOX 5213
Second Line :
City : EVANSTON
State : IL
Zip : 60204-5213
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1854 SHERMAN AVE
Second Line :
City : EVANSTON
State : IL
Zip : 60201-3795
Country : US
Telephone Number : 857-565-6400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/07/2019
Last Update Date : 02/09/2026

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Directions to “ NAOMI WACHS ” Practice Location

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