Individual
MISS ABIGAIL RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSW
Contact information
Practice address
5097 N ELSTON AVE, CHICAGO, IL 60630-2463
(312) 296-8627
Mailing address
5097 N ELSTON AVE, CHICAGO, IL 60630-2463
(312) 296-8627
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R160-0009-8925
LICENSE
IL
Enumeration date
07/02/2021
Last updated
07/02/2021
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