Individual
KIEFER GILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
20676 RIDGEVIEW LN, MARENGO, IL 60152-8616
(815) 919-3792
Mailing address
20676 RIDGEVIEW LN, MARENGO, IL 60152-8616
(815) 919-3792
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
G40051395236
IL
Other
Enumeration date
05/04/2015
Last updated
05/04/2015
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