Individual
KRYSTIANA DISBROW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3125 W 103RD ST, CHICAGO, IL 60655-2009
(708) 288-3688
Mailing address
3125 W 103RD ST, CHICAGO, IL 60655-2009
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.103113
IL
Other
Enumeration date
12/01/2022
Last updated
12/01/2022
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