7739956300

Clinical Social Worker · Chicago, IL

Organization Active NPI

NPI number 1336685494

Practice location

1029 E 130TH St
Chicago, IL 60628-6908
Phone
(773) 995-6300
Fax
(773) 995-6192

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NPI record

NPI
1336685494
Entity type
Organization (Type 2)
Enumeration date
January 13, 2017
Last updated
January 13, 2017
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Clinical Social Worker Primary 1041C0700X 149018713 IL

Mailing address

1029 E.130TH Street
Chicago, IL 60628
Phone
(773) 995-6300
Fax
(773) 995-6192

Authorized official

Name
Ms. Marquetta D Hall, CPCS
Title
Billing Coding Specialist
Phone
(773) 995-6300

Other names

  • Tca Health Care

About 7739956300

7739956300 is a healthcare organization registered in the NPI registry with the primary taxonomy Clinical Social Worker (code 1041C0700X). The practice location is 1029 E 130TH St, Chicago, IL 60628-6908. The NPI number 1336685494 was assigned on January 13, 2017 and the record was last updated on January 13, 2017.

7739956300 lists a license in the registry: #149018713 (IL) for Clinical Social Worker. License numbers are self-reported to NPPES; verify them with the state licensing board.

The authorized official for this organization is Ms. Marquetta D Hall, CPCS, Billing Coding Specialist.

Frequently asked questions

What is the NPI number of 7739956300?

The NPI number is 1336685494.

What is the phone number of 7739956300?

The phone number listed for the practice location is (773) 995-6300.

Where is 7739956300 located?

1029 E 130TH St, Chicago, IL 60628-6908.

What is the taxonomy code for 7739956300?

The primary taxonomy code is 1041C0700X – Clinical Social Worker.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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