Individual
DOROTHY RANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
12145 WESTERN AVE, BLUE ISLAND, IL 60406-1387
(773) 537-3930
Mailing address
667 PRIMROSE LN, MATTESON, IL 60443-1762
(708) 769-6217
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.102117
IL
Other
Enumeration date
11/05/2018
Last updated
11/05/2018
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