MEDICARE: TAYLOR PATETE

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	149.029123	IL

General Provider Information

NPI Number	:	1942198866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR PATETE

Provider Business Mailing Address
First Line	:	5019 W RANDOLPH CT
Second Line	:
City	:	HILLSIDE
State	:	IL
Zip	:	60162-1022
Country	:	US
Telephone Number	:	630-246-0599
Fax Number	:

Provider Business Practice Location Address
First Line	:	2209 W WASHINGTON BLVD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-2422
Country	:	US
Telephone Number	:	312-883-3037
Fax Number	:

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

Provider Enumeration Date	:	06/27/2025
Last Update Date	:	06/27/2025

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Directions to “ TAYLOR PATETE ” Practice Location

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