Individual
MRS. JEAN M SUNDERLAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
44W039 PLANK RD, HAMPSHIRE, IL 60140-8438
(847) 347-0186
Mailing address
44W039 PLANK RD, HAMPSHIRE, IL 60140
(847) 347-0186
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.000883
IL
Other
Enumeration date
02/16/2012
Last updated
02/16/2012
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