Organization
FORTYTHIRTYONE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NADA MARIE BRZOVICH LCSW (PRESIDENT)
(847) 827-0600
Entity
Organization
Contact information
Practice address
1580 N NORTHWEST HWY, SUITE 312, PARK RIDGE, IL 60068-1444
(847) 827-0600
(877) 481-0769
Mailing address
1580 N NORTHWEST HWY, SUITE 312, PARK RIDGE, IL 60068-1444
(847) 827-0600
(877) 481-0769
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149010861
IL
Other
Enumeration date
04/05/2016
Last updated
04/05/2016
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