MEDICARE: MARLA MICOR 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	149.022836	IL

General Provider Information

NPI Number	:	1922690759
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARLA MICOR LCSW

Provider Business Mailing Address
First Line	:	333 N MICHIGAN AVE STE 1400
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60601-4011
Country	:	US
Telephone Number	:	312-815-9660
Fax Number	:

Provider Business Practice Location Address
First Line	:	3508 W CORTLAND ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-4855
Country	:	US
Telephone Number	:	773-359-3464
Fax Number	:

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

Provider Enumeration Date	:	02/03/2021
Last Update Date	:	02/16/2026

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Directions to “ MARLA MICOR LCSW” Practice Location

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