Individual
BENJAMIN NISHAN WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
415 WASHINGTON ST STE 200, WAUKEGAN, IL 60085-5564
(847) 441-5600
Mailing address
3657 N WHIPPLE ST APT 1F, CHICAGO, IL 60618-4519
(559) 799-1139
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
07/25/2024
Last updated
07/25/2024
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