Individual
JENNIFER LABRADOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
4740 N CLARK ST, CHICAGO, IL 60640-4689
(773) 769-0205
(773) 765-0794
Mailing address
4740 N CLARK ST, CHICAGO, IL 60640-4689
(773) 769-0205
(773) 765-0794
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150011316
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1616824
BLUE SHIELD
IL
Enumeration date
07/21/2011
Last updated
07/21/2011
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