| Cece Cornell Lcsw Llc | |
|
1331 N Mohawk St Unit 1 Chicago IL 60610-1713 | |
| (312) 550-8707 | |
| Not Available |
| Full Name | Cece Cornell Lcsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1331 N Mohawk St Unit 1, Chicago, Illinois |
| Authorized Official Name and Position | Cecelia S. Cornell (MEMBER) |
| Authorized Official Contact | 3125508707 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cece Cornell Lcsw Llc 1331 N Mohawk St Unit 1 Chicago IL 60610-1713 Ph: (312) 550-8707 | Cece Cornell Lcsw Llc 1331 N Mohawk St Unit 1 Chicago IL 60610-1713 Ph: (312) 550-8707 |
| NPI Number | 1346753597 |
|---|---|
| Provider Enumeration Date | 11/09/2017 |
| Last Update Date | 11/09/2017 |
| Medicare PECOS PAC ID | 1153660071 |
|---|---|
| Medicare Enrollment ID | O20190311001798 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346753597 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 149008739 (Illinois) | Primary |
| Provider Name | Cecelia S Cornell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497994354 PECOS PAC ID: 5496992711 Enrollment ID: I20130506000103 |
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