MEDICARE: YWCA METROPOLITAN CHICAGO

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

General Provider Information

NPI Number	:	1962178327
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YWCA METROPOLITAN CHICAGO

Provider Business Mailing Address
First Line	:	1 NORTH LASALLE
Second Line	:	STE. 1700
City	:	CHICAGO
State	:	IL
Zip	:	60602
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6600 S COTTAGE GROVE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60637-4127
Country	:	US
Telephone Number	:	773-955-3100
Fax Number	:

Authorized Official
Title or Position	:	CHIEF EMPOWERMENT OFFICER
Name	:	LOREN SIMMONS
Credential	:
Telephone Number	:	312-762-2771

Provider Enumeration Date	:	08/17/2021
Last Update Date	:	05/24/2022

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