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1730763228
LESLIE JOEL ILLIDGE
CHICAGO, IL
NPI
1730763228
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
104100000X Social Worker
(Licence: IL 150007727)
Enumeration Date
2021-05-10
Last Update Date
2021-05-10
Business Address
Mr. LESLIE JOEL ILLIDGE
8530 S SAINT LAWRENCE AVE
CHICAGO, IL 60619-6025
Phone number: 773-852-0642
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Mailing Address
Mr. LESLIE JOEL ILLIDGE
8530 S SAINT LAWRENCE AVE
CHICAGO, IL 60619-6025
Phone number: 773-852-0642
Copy
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