Individual
ENA ISIS MILLWARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
U
Credential
LCSW
Contact information
Practice address
1719 N RUTHERFORD AVE, CHICAGO, IL 60707-3942
(773) 707-6093
Mailing address
1719 N RUTHERFORD AVE, CHICAGO, IL 60707-3942
(773) 707-6093
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
089.0136253TELE
VT
1041C0700X
Clinical Social Worker
Primary
149.027579
IL
Other
Enumeration date
08/24/2024
Last updated
12/02/2024
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