Individual
STORM DADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2023 RIDGE RD UNIT 2NW, HOMEWOOD, IL 60430-1786
(708) 580-6042
Mailing address
4137 OAKWOOD LN, MATTESON, IL 60443-1920
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/03/2021
Last updated
02/03/2021
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