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NPI Code Detail

MEDICARE: FELICIA R. STANTON LCSW

MEDICARE:   FELICIA R. STANTON  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 Worker149.007975IL

General Provider Information

NPI Number : 1780894550
Entity Type Code : Individual
Provider Name (Legal Business Name) : FELICIA R. STANTON LCSW
Provider Business Mailing Address
First Line : 4528 S PRAIRIE AVE # 3
Second Line :
City : CHICAGO
State : IL
Zip : 60653-3912
Country : US
Telephone Number : 773-268-3300
Fax Number : 773-268-3300
Provider Business Practice Location Address
First Line : 4528 S PRAIRIE AVE # 3
Second Line :
City : CHICAGO
State : IL
Zip : 60653-3912
Country : US
Telephone Number : 773-268-3300
Fax Number : 773-268-3300
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2007
Last Update Date : 07/08/2007

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Directions to “ FELICIA R. STANTON LCSW” Practice Location

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