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1093806614
JEFFREY N BLAINE
CHICAGO, IL
NPI
1093806614
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: IL 149-000197)
Enumeration Date
2006-09-27
Last Update Date
2007-07-08
Business Address
-- JEFFREY N BLAINE L.C.S.W.
20 N CLARK ST SUITE 2650
CHICAGO, IL 60602-4109
Phone number: 312-558-1573
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Mailing Address
-- JEFFREY N BLAINE L.C.S.W.
803 MONROE AVE
RIVER FOREST, IL 60305-1421
Phone number: 312-656-5361
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