1689773111 NPI number — MRS. MONICA MORRIS SCHWARTZ LCSW

Table of content: MRS. MONICA MORRIS SCHWARTZ LCSW (NPI 1689773111)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689773111 NPI number — MRS. MONICA MORRIS SCHWARTZ LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHWARTZ
Provider First Name:
MONICA
Provider Middle Name:
MORRIS
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1689773111
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5519 SOUTH KIMBARK AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHICAGO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60637
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
773-363-5559
Provider Business Mailing Address Fax Number:
773-363-5565

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
PILLARS FILLMORE CENTER 6918 WINDSOR AVE BERWYN IL 6040
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BERWYN
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60402
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
708-795-4800
Provider Business Practice Location Address Fax Number:
708-795-4834
Provider Enumeration Date:
09/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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