Individual
FADUMO OMAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
635 W GRACE ST APT 1504, CHICAGO, IL 60613-4062
(773) 759-9447
Mailing address
635 W GRACE ST APT 1504, CHICAGO, IL 60613-4062
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180014176
IL
Other
Enumeration date
01/06/2022
Last updated
02/08/2022
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