Individual
AMELIA EADES KOPLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3545 LAKE AVE STE 200, WILMETTE, IL 60091-1058
(847) 251-7350
Mailing address
430 10TH ST, WILMETTE, IL 60091-2733
(312) 305-9882
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149009860
IL
Other
Enumeration date
05/30/2018
Last updated
05/30/2018
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