Individual
MISS BISOLA ELIZABETH ATINSOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
801 N WALNUT ST, CHAMPAIGN, IL 61820-3055
(217) 722-6014
Mailing address
1021 N MULFORD RD, ROCKFORD, IL 61107-3874
(217) 722-6014
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150105697
IL
Other
Enumeration date
01/17/2022
Last updated
01/17/2022
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