Organization
MATTHEW BOLTZ LCSW, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW BOLTZ LCSW (OWNER/MANAGER)
(630) 479-9640
Entity
Organization
Contact information
Practice address
505 W MELROSE ST APT 401, CHICAGO, IL 60657-3726
(312) 985-6023
Mailing address
505 W MELROSE ST APT 401, CHICAGO, IL 60657-3726
(630) 479-9640
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
08/11/2022
Last updated
08/11/2022
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