Provider Demographics
NPI:1952106932
Name:MALKIN, NOA CHANA (LSW)
Entity type:Individual
Prefix:
First Name:NOA
Middle Name:CHANA
Last Name:MALKIN
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:NOA
Other - Middle Name:CHANA
Other - Last Name:ROMANOFF
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6547 N RICHMOND ST APT 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-4289
Mailing Address - Country:US
Mailing Address - Phone:312-765-3538
Mailing Address - Fax:
Practice Address - Street 1:7366 N LINCOLN AVE STE 310
Practice Address - Street 2:
Practice Address - City:LINCOLNWOOD
Practice Address - State:IL
Practice Address - Zip Code:60712-1740
Practice Address - Country:US
Practice Address - Phone:312-834-7616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.114701104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker