MEDICARE: INDRIG LADDEN 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	149.018520	IL
2	104100000X	Social Worker	150.015341	IL

General Provider Information

NPI Number	:	1922406412
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	INDRIG LADDEN LCSW

Provider Business Mailing Address
First Line	:	5756 N RIDGE AVE STE 11
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60660-5333
Country	:	US
Telephone Number	:	441-442-4449
Fax Number	:

Provider Business Practice Location Address
First Line	:	5237 N CLARK ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-2122
Country	:	US
Telephone Number	:	331-442-4449
Fax Number	:

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

Provider Enumeration Date	:	12/15/2014
Last Update Date	:	03/10/2026

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