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1104971712
KEITH V. WALLACE
CHICAGO, IL
NPI
1104971712
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
104100000X Social Worker
(Licence: IL 149-012034)
Enumeration Date
2007-01-24
Last Update Date
2008-10-27
Business Address
Mr. KEITH V. WALLACE L.C.S.W.
CHILDREN'S MEMORIAL HOSPITAL 2300 CHILDREN'S PLAZA, BOX 10
CHICAGO, IL 60614
Phone number: 773-975-8604
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Mailing Address
Mr. KEITH V. WALLACE L.C.S.W.
CHILDREN'S MEMORIAL HOSPITAL 2300 CHILDREN'S PLAZA, BOX 10
CHICAGO, IL 60614
Phone number: 773-975-8604
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