Individual
MR. DOUGLAS EUGENE MITCHEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1600 RIVERDALE RD LOT 42, ROCK FALLS, IL 61071-2450
(815) 441-4195
Mailing address
1600 RIVERDALE RD LOT 42, ROCK FALLS, IL 61071-2450
(815) 441-4195
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
12/20/2008
Last updated
12/20/2008
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