Individual
MR. EUSEBIO ENRIQUE CAMACHO MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, LSW MASTERS
Contact information
Practice address
2720 S RIVER RD STE 246, DES PLAINES, IL 60018-4111
(219) 766-4700
Mailing address
550 S HANCOCK ST, GARY, IN 46403-2403
(219) 689-6125
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
150105643
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316027998
—
IN
Enumeration date
09/30/2015
Last updated
01/29/2024
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