MEDICARE: JENNIFER CURLEY 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	149.020780	IL

General Provider Information

NPI Number	:	1952872814
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER CURLEY LCSW

Provider Business Mailing Address
First Line	:	5317 N CLARK ST # 2
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-2113
Country	:	US
Telephone Number	:	773-273-9002
Fax Number	:

Provider Business Practice Location Address
First Line	:	5317 N CLARK ST # 2
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-2113
Country	:	US
Telephone Number	:	773-273-9002
Fax Number	:

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

Provider Enumeration Date	:	12/17/2018
Last Update Date	:	05/19/2023

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