Individual
AMI GOETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW, PEL
Contact information
Practice address
3001 N SOUTHPORT AVE FL 2, CHICAGO, IL 60657-4289
(773) 799-8966
Mailing address
3001 N SOUTHPORT AVE FL 2, CHICAGO, IL 60657-4289
(773) 799-8966
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
150.108783
LICENSED SOCIAL WORKER
IL
Enumeration date
07/05/2022
Last updated
08/23/2022
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