MEDICARE: HEATHER M BREEMS 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
1	1041C0700X	Clinical Social Worker	149.014749	IL

General Provider Information

NPI Number	:	1912773292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER M BREEMS LCSW

Provider Business Mailing Address
First Line	:	2212 W 37TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60609-1039
Country	:	US
Telephone Number	:	773-383-3331
Fax Number	:

Provider Business Practice Location Address
First Line	:	2212 W 37TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60609-1039
Country	:	US
Telephone Number	:	773-383-3331
Fax Number	:

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

Provider Enumeration Date	:	11/28/2023
Last Update Date	:	11/28/2023

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Directions to “ HEATHER M BREEMS LCSW” Practice Location

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