Individual
FAE KOBERNIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
4711 N BROADWAY ST, CHICAGO, IL 60640-4908
(773) 234-3212
Mailing address
4711 N BROADWAY ST, CHICAGO, IL 60640-4908
(773) 234-3212
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
06/12/2025
Last updated
06/12/2025
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