NPI 1174904965 · live from the CMS NPI Registry
John Acevedo
Social Worker, Clinical in Chicago, IL. National Provider Identifier 1174904965, active.
NPI record
| NPI | 1174904965 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Social Worker, Clinical 1041C0700X |
| Practice location | 451 N. Lasalle St., Chicago, IL 60654 |
| Practice phone | 312-755-2250 |
| Mailing address | 5835 N Winthrop Ave Apt 1, Chicago, IL 60660 |
| Enumerated | June 17, 2015 |
| Last updated | June 17, 2015 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Social Worker, Clinical primary | 1041C0700X | 149.017375 (IL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.