Amalia Golomb-Leavitt | Chicago, IL • PECOS Search

Amalia Golomb-Leavitt

Social Worker

Behavioral Health & Social Service Providers

1000 W Diversey Pkwy Ste 275, Chicago, IL 60614-1879

PECOS Enrollment

Based on the most recent information from CMS, provider Amalia Golomb-Leavitt does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1053083824
Provider Type
Individual
Full Name
Golomb-Leavitt, Amalia
Credential
A.M., LSW

Gender
Female
Sole Proprietor
No
Enumeration Date
9/30/2021
Last Updated
9/30/2021

Contact Information

Practice Location

1000 W Diversey Pkwy Ste 275, Chicago, IL 60614-1879

Unlisted Fax

Mailing Location

1000 W Diversey Pkwy Ste 275, Chicago, IL 60614-1879

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 150.105432 Illinois