Individual
AIDE FONSECA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4531 IDLEWILD LN, HILLSIDE, IL 60162-1755
(708) 846-4812
Mailing address
4531 IDLEWILD LN, HILLSIDE, IL 60162-1755
(708) 846-4812
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149021200
IL
Other
Enumeration date
01/18/2021
Last updated
01/18/2021
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