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NPI Code Detail

MEDICARE: ELLA LEMBERIS LCSW

MEDICARE:   ELLA  LEMBERIS  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
11041C0700XClinical Social Worker149.016664IL

General Provider Information

NPI Number : 1962936674
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELLA LEMBERIS LCSW
Provider Business Mailing Address
First Line : 11030 S SAINT LOUIS AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60655-3322
Country : US
Telephone Number : 773-469-1631
Fax Number :
Provider Business Practice Location Address
First Line : 11030 S SAINT LOUIS AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60655-3322
Country : US
Telephone Number : 773-469-1631
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2017
Last Update Date : 04/19/2017

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Directions to “ ELLA LEMBERIS LCSW” Practice Location

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