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NPI Code Detail

MEDICARE: LISA ZIEMS LCSW

MEDICARE: LISA ZIEMS 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
11041C0700XClinical Social WorkerIL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10091640455OTHERILBCBS PROVIDER NUMBER
20001634914OTHERILBCBS PROVIDER NUMBER
30091640430OTHERILBCBS PROVIDER NUMBER

General Provider Information

NPI Number : 1902918261
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA ZIEMS LCSW
Provider Business Mailing Address
First Line : 1720 N KEDZIE AVE
Second Line : UNIT J
City : CHICAGO
State : IL
Zip : 60647-4968
Country : US
Telephone Number : 773-227-7710
Fax Number :
Provider Business Practice Location Address
First Line : 10537 S ROBERTS RD
Second Line :
City : PALOS HILLS
State : IL
Zip : 60465-1933
Country : US
Telephone Number : 708-974-5816
Fax Number : 708-974-2498
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 07/08/2007

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Directions to “ LISA ZIEMS LCSW” Practice Location

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