Provider Demographics
NPI:1558023176
Name:SILVA DE OLIVEIRA, SORAIA
Entity Type:Individual
Prefix:
First Name:SORAIA
Middle Name:
Last Name:SILVA DE OLIVEIRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1434 W LUNT AVE APT 1N
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626-6087
Mailing Address - Country:US
Mailing Address - Phone:414-731-6413
Mailing Address - Fax:
Practice Address - Street 1:180 N MICHIGAN AVE STE 1040
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-7421
Practice Address - Country:US
Practice Address - Phone:312-346-5156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-11
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1501039021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical