Individual ProviderScott KupferschmidtSocial WorkerBehavioral Health & Social Service ProvidersPractice Address1030 N Clark St Ste 303, Chicago, IL 60610-5453(773) 793-5625PECOS EnrollmentBased on the most recent information from CMS, provider Scott Kupferschmidt does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1578316675Provider TypeIndividualFull NameKupferschmidt, ScottCredentialLCSWGenderMaleSole ProprietorYesEnumeration Date4/9/2024Last Updated4/9/2024Contact InformationPractice LocationPractice Address1030 N Clark St Ste 303, Chicago, IL 60610-5453Phone(773) 793-5625FaxUnlisted FaxMailing LocationMailing Address2942 W Belle Plaine Ave Apt 3e, Chicago, IL 60618-2669Phone(773) 793-5625FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense149025662Illinois