Individual
DIANA EVELYN GALLARDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1122 BOB OFARRELL LN, BEACH PARK, IL 60099-4512
(224) 595-7454
Mailing address
420 N OAKWOOD AVE, WAUKEGAN, IL 60085-3015
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.105877
IL
Other
Enumeration date
03/07/2022
Last updated
12/12/2022
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