| Susan Bachman, Lcsw,sc | |
|
2132 W Roscoe St Chicago IL 60618-6241 | |
| (773) 880-0947 | |
| Not Available |
| Full Name | Susan Bachman, Lcsw,sc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2132 W Roscoe St, Chicago, Illinois |
| Authorized Official Name and Position | Susan Bachman (OWNER/PRESIDENT) |
| Authorized Official Contact | 7738800947 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Susan Bachman, Lcsw,sc 2132 W Roscoe St Chicago IL 60618-6241 Ph: () - | Susan Bachman, Lcsw,sc 2132 W Roscoe St Chicago IL 60618-6241 Ph: (773) 880-0947 |
| NPI Number | 1457817264 |
|---|---|
| Provider Enumeration Date | 02/17/2019 |
| Last Update Date | 02/17/2019 |
| Medicare PECOS PAC ID | 0547502205 |
|---|---|
| Medicare Enrollment ID | O20190429001148 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457817264 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Susan M Bachman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720543689 PECOS PAC ID: 9032451794 Enrollment ID: I20190429001444 |
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