MEDICARE: HEIDI COLEMAN 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	149014640	IL

General Provider Information

NPI Number	:	1821389107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEIDI COLEMAN LCSW

Provider Business Mailing Address
First Line	:	9236 S WINCHESTER AVE STE 2416
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60643-6307
Country	:	US
Telephone Number	:	312-607-7487
Fax Number	:

Provider Business Practice Location Address
First Line	:	1525 E 53RD ST STE 806
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60615-4572
Country	:	US
Telephone Number	:	312-351-9599
Fax Number	:

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

Provider Enumeration Date	:	04/21/2011
Last Update Date	:	04/01/2023

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Directions to “ HEIDI COLEMAN LCSW” Practice Location

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