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NPI Code Detail

MEDICARE: MARGARET GRACE MOORE LSW

MEDICARE: MARGARET GRACE MOORE LSW
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 Worker150117848IL

General Provider Information

NPI Number : 1831032192
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARGARET GRACE MOORE LSW
Provider Business Mailing Address
First Line : 1652 W BELMONT AVE APT 2F
Second Line :
City : CHICAGO
State : IL
Zip : 60657-3091
Country : US
Telephone Number : 317-219-8854
Fax Number :
Provider Business Practice Location Address
First Line : 1431 N CLAREMONT AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60622-1702
Country : US
Telephone Number : 877-937-4744
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2026
Last Update Date : 04/13/2026

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Directions to “ MARGARET GRACE MOORE LSW” Practice Location

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