Individual
MIKAIL BASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17114 WHITTIER AVE, HAZEL CREST, IL 60429-1120
(708) 646-4467
Mailing address
17114 WHITTIER AVE, HAZEL CREST, IL 60429-1120
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.102404
IL
Other
Enumeration date
04/01/2019
Last updated
04/01/2019
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