Provider Demographics
NPI:1780042788
Name:SILVER, MATTHEW ADAM (LCSW)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:ADAM
Last Name:SILVER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1958 W WINONA ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-2661
Mailing Address - Country:US
Mailing Address - Phone:773-350-2462
Mailing Address - Fax:
Practice Address - Street 1:992 1/2 GREEN BAY RD
Practice Address - Street 2:
Practice Address - City:WINNETKA
Practice Address - State:IL
Practice Address - Zip Code:60093-1722
Practice Address - Country:US
Practice Address - Phone:847-446-8060
Practice Address - Fax:847-446-9768
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-04
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL25641101YA0400X
IL149.0182341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)