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NPI Code Detail

MEDICARE: MICHELLE D WILLIAMS LCSW, CADC

MEDICARE: MICHELLE D WILLIAMS LCSW, CADC
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 WorkerIL

General Provider Information

NPI Number : 1841361177
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE D WILLIAMS LCSW, CADC
Provider Business Mailing Address
First Line : 3410 W ROOSEVELT RD APT 2
Second Line :
City : CHICAGO
State : IL
Zip : 60624-4352
Country : US
Telephone Number : 773-722-8515
Fax Number :
Provider Business Practice Location Address
First Line : 3410 W ROOSEVELT RD
Second Line :
City : CHICAGO
State : IL
Zip : 60624-4343
Country : US
Telephone Number : 773-722-8515
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/10/2006
Last Update Date : 07/08/2007

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