Individual
MR. MARIO ANTONIO FAVELA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
820 S DAMEN AVE, CHICAGO, IL 60612-3728
(312) 569-8462
Mailing address
820 S DAMEN AVE, CHICAGO, IL 60612-3728
(312) 569-8462
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
12/17/2010
Last updated
12/17/2010
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