MEDICARE: RADINA CHELEVA MSW

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	104100000X	Social Worker	150105739	IL

General Provider Information

NPI Number	:	1831833292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RADINA CHELEVA MSW

Provider Business Mailing Address
First Line	:	5606 TINDER
Second Line	:
City	:	ROLLING MEADOWS
State	:	IL
Zip	:	60008-4135
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2135 W ROSCOE ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-6275
Country	:	US
Telephone Number	:	312-219-4459
Fax Number	:

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

Provider Enumeration Date	:	04/22/2022
Last Update Date	:	08/03/2023

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