NPI 1942403290 · live from the CMS NPI Registry
Maducolil Mathai Abraham, LCSW, ACSW
Social Worker, Clinical in Chicago, IL. National Provider Identifier 1942403290, active.
NPI record
| NPI | 1942403290 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Social Worker, Clinical 1041C0700X |
| Practice location | 820 S Damen Ave, Chicago, IL 60612 |
| Practice phone | 312-569-8063 |
| Mailing address | 1110 Longford Dr, Westmont, IL 60559 |
| Enumerated | June 6, 2007 |
| Last updated | July 8, 2007 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Social Worker, Clinical primary | 1041C0700X | 149002489 (IL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.