Individual
KIMBERLY PHELPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
224 LAKE ST, OAK PARK, IL 60302-4685
(866) 727-1194
Mailing address
3110 W 114TH ST, MERRIONETTE PARK, IL 60803-4593
(708) 606-9577
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.114341
IL
Other
Enumeration date
09/23/2024
Last updated
09/23/2024
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