Individual
MR. ALFONSO R LARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1730 WASHINGTON ST, WAUKEGAN, IL 60085-5102
(224) 374-8792
Mailing address
1730 WASHINGTON ST, WAUKEGAN, IL 60085-5102
(224) 374-8792
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
10/02/2024
Last updated
10/02/2024
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