Basic Information
Provider Information
NPI: 1720598618
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MEGYERI
FirstName: CSILLA
MiddleName: BOKOR
NamePrefix:  
NameSuffix:  
Credential: LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5215 N CALIFORNIA AVE STE F101
Address2:  
City: CHICAGO
State: IL
PostalCode: 606250035
CountryCode: US
TelephoneNumber: 7735615809
FaxNumber: 7735615946
Practice Location
Address1: 5215 N CALIFORNIA AVE STE F101
Address2:  
City: CHICAGO
State: IL
PostalCode: 606250035
CountryCode: US
TelephoneNumber: 7735615809
FaxNumber: 7735615946
Other Information
ProviderEnumerationDate: 10/04/2017
LastUpdateDate: 10/04/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X149.019692ILY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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