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1912000167
RUSSELL C LEBLANC
CHICAGO, IL
NPI
1912000167
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: IL 149.004212)
Enumeration Date
2006-09-06
Last Update Date
2007-07-08
Business Address
Mr. RUSSELL C LEBLANC LCSW
820 S DAMEN AVE
CHICAGO, IL 60612-3728
Phone number: 312-569-6879
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Mailing Address
Mr. RUSSELL C LEBLANC LCSW
4214 N MELVINA AVE
CHICAGO, IL 60634-1528
Phone number: 773-777-5887
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