Individual
DEVETA KAMIL GELISPIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
5000 S 5TH AVE BLDG 2284TH, HINES, IL 60141-3030
(708) 202-4952
Mailing address
4853 S VINCENNES AVE UNIT 305, CHICAGO, IL 60615-1478
(312) 890-4205
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150101980
IL
Other
Enumeration date
11/29/2017
Last updated
11/29/2017
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