Organization
AMY TANNER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY E TANNER LCSW (SOCIAL WORKER)
(773) 430-1075
Entity
Organization
Contact information
Practice address
4305 N LINCOLN AVE STE K, CHICAGO, IL 60618-1807
(773) 430-1075
Mailing address
6351 W MONTROSE AVE STE 180, CHICAGO, IL 60634-1563
(773) 430-1075
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/21/2020
Last updated
10/21/2020
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