MEDICARE: MS. MEREDITH ERIN LEE 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
1	1041C0700X	Clinical Social Worker	149.016286	IL

General Provider Information

NPI Number	:	1770941247
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MEREDITH ERIN LEE LCSW

Provider Business Mailing Address
First Line	:	700 N GREEN ST STE 303
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60642-5996
Country	:	US
Telephone Number	:	312-529-8145
Fax Number	:	312-489-8293

Provider Business Practice Location Address
First Line	:	700 N GREEN ST STE 303
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60642-5996
Country	:	US
Telephone Number	:	312-529-8145
Fax Number	:	312-489-8293

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

Provider Enumeration Date	:	01/29/2016
Last Update Date	:	09/08/2021

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