Individual
LAUREN ELIZABETH WIDAMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7357 W NORTH AVENUE, RIVER FOREST, IL 60305-1230
(773) 270-0469
Mailing address
1806 N DAMEN AVE, CHICAGO, IL 60647-5511
(773) 270-0469
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.109640
IL
Other
Enumeration date
12/06/2022
Last updated
08/24/2023
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