Provider Demographics
NPI:1417040148
Name:ANDRADE, AMALIA (MSW)
Entity Type:Individual
Prefix:
First Name:AMALIA
Middle Name:
Last Name:ANDRADE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3770 W. HAYFORD ST.
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60652
Mailing Address - Country:US
Mailing Address - Phone:773-865-5945
Mailing Address - Fax:
Practice Address - Street 1:5341 W. CERMAK RD.
Practice Address - Street 2:
Practice Address - City:CICERO
Practice Address - State:IL
Practice Address - Zip Code:60804
Practice Address - Country:US
Practice Address - Phone:708-656-6430
Practice Address - Fax:708-656-6591
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker