Individual
ELISA CISNEROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3010 GRAND AVE, WAUKEGAN, IL 60085-2321
(847) 377-8955
Mailing address
3010 GRAND AVE, WAUKEGAN, IL 60085-2321
(847) 377-8955
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150011882
IL
Other
Enumeration date
12/28/2018
Last updated
12/28/2018
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