| Nancy Smith L.c.s.w.,p.c. | |
|
4753 N Broadway St #928 Chicago IL 60640-5266 | |
| (773) 878-8440 | |
| Not Available |
| Full Name | Nancy Smith L.c.s.w.,p.c. |
|---|---|
| Speciality | Social Worker |
| Location | 4753 N Broadway St, Chicago, Illinois |
| Authorized Official Name and Position | Nancy Smith (PSYCHOTHERAPIST) |
| Authorized Official Contact | 7738788440 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nancy Smith L.c.s.w.,p.c. 4753 N Broadway St #928 Chicago IL 60640-5266 Ph: (773) 878-8440 | Nancy Smith L.c.s.w.,p.c. 4753 N Broadway St #928 Chicago IL 60640-5266 Ph: (773) 878-8440 |
| NPI Number | 1780863142 |
|---|---|
| Provider Enumeration Date | 11/01/2007 |
| Last Update Date | 01/16/2008 |
| Medicare PECOS PAC ID | 0941380281 |
|---|---|
| Medicare Enrollment ID | O20071228000024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780863142 | NPI | - | NPPES |
| 215888 | Other | IL | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (Illinois) | Primary |
| Provider Name | Nancy A Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326106188 PECOS PAC ID: 9032299375 Enrollment ID: I20071228000023 |
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