| Susan Love Lcsw Llc | |
|
408 Center St Grayslake IL 60030-1626 | |
| (847) 223-4996 | |
| Not Available |
| Full Name | Susan Love Lcsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 408 Center St, Grayslake, Illinois |
| Authorized Official Name and Position | Susan D. Love (MEMBER) |
| Authorized Official Contact | 8472234996 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Susan Love Lcsw Llc 113 Burton St Grayslake IL 60030-1507 Ph: (847) 223-4996 | Susan Love Lcsw Llc 408 Center St Grayslake IL 60030-1626 Ph: (847) 223-4996 |
| NPI Number | 1215590740 |
|---|---|
| Provider Enumeration Date | 04/19/2019 |
| Last Update Date | 04/19/2019 |
| Medicare PECOS PAC ID | 3870828775 |
|---|---|
| Medicare Enrollment ID | O20190715003118 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215590740 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Susan D Love |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447649603 PECOS PAC ID: 8820308166 Enrollment ID: I20151117000859 |
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