Individual
CRAIG MIROBALLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ED.S.
Contact information
Practice address
42 W MADISON ST, CHICAGO, IL 60602-4309
(312) 208-7171
Mailing address
42 W MADISON ST, CHICAGO, IL 60602-4309
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1878689
ISBE
IL
Enumeration date
11/19/2021
Last updated
11/19/2021
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