Individual
MR. SAIPRASEUTH CHALEUNPHONH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
1404 TAYLOR STREET, JOLIET, IL 60435-5736
(815) 729-9563
Mailing address
1404 TAYLOR STREET, JOLIET, IL 60435-5736
(815) 729-9563
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150007491
IL
Other
Enumeration date
07/03/2008
Last updated
07/03/2008
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