MEDICARE: MRS. ROBERTA A WINTER 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	1041C0700X	Clinical Social Worker	149003675	IL

General Provider Information

NPI Number	:	1881849453
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ROBERTA A WINTER MSW

Provider Business Mailing Address
First Line	:	9020 KNIGHT AVE
Second Line	:
City	:	DES PLAINES
State	:	IL
Zip	:	60016-5155
Country	:	US
Telephone Number	:	847-803-8096
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 N WACKER DR
Second Line	:	SUITE 1442
City	:	CHICAGO
State	:	IL
Zip	:	60606-2806
Country	:	US
Telephone Number	:	312-372-4731
Fax Number	:

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

Provider Enumeration Date	:	11/24/2008
Last Update Date	:	11/24/2008

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