Individual
EUGINIA IVANOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, CADC
Contact information
Practice address
3410 W. ROOSEVELT RD, CHICAGO, IL 60624
(773) 840-8083
(773) 826-2966
Mailing address
3410 W ROOSEVELT RD, CHICAGO, IL 60624-4343
(773) 840-8083
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
150105132
IL
1041C0700X
Clinical Social Worker
Primary
149023678
IL
Other
Enumeration date
10/19/2020
Last updated
12/15/2021
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