Individual
BETH ILANNA KIBORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4822 N BROADWAY ST, 2ND FLOOR, CHICAGO, IL 60640-3604
(773) 433-1200
Mailing address
2614 FARNSWORTH LN, NORTHBROOK, IL 60062-5921
(312) 515-0376
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.012596
IL
Other
Enumeration date
04/22/2011
Last updated
04/22/2011
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