Thomas Robert Undine LCSW

NPI 1245499151 - Social Worker - 1041S0200X

NPI Details
NPI 1245499151
Gender Male
Enumeration Date 06/05/2008
Last Updated 07/21/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
4958 N MILWAUKEE AVE
CHICAGO IL, 60630, US
Phone (773) 207-8500
Fax
Business Location
2901 FINLEY RD
SUITE 102
DOWNERS GROVE IL, 60515-1041, US
Phone (630) 495-6800
Fax (630) 495-8200
Toxanomy
Taxonomy Code 1041S0200X
License State Illinois
License Number 2239902
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According to our database, Mr. Thomas Robert Undine LCSW NPI is 1245499151, taxonomy code is 1041S0200X and license number is 2239902, license state is located at Illinois. Thomas Robert Undine LCSW physically located at 4958 N Milwaukee Ave, Chicago IL, 60630. NPI Number Thomas Robert Undine LCSW has the Individual type.

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1245499151 NPI number is provided on an as is basis without warranty of any kind. 1245499151 is maintained by the National Plan & Provider Enumeration System. The contents of Thomas Robert Undine LCSW are for informational purposes only.