GLEN FORNERIS

ROCKFORD, IL
NPI1073021192
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: IL  149017684)
Enumeration Date2018-01-11
Last Update Date2018-01-11
Business Address
GLEN FORNERIS
1021 N MULFORD RD
ROCKFORD, IL 61107-3877
Phone number: 815-387-5600
Mailing Address
GLEN FORNERIS
1021 N MULFORD RD
ROCKFORD, IL 61107-3877
Phone number: 815-387-5600
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