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Individual

DIEGO VINTIMILLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
715 LAKE ST STE 720&800, OAK PARK, IL 60301-1422
(773) 312-3612
Mailing address
810 N CLARK ST APT 1207, CHICAGO, IL 60610-3625
(312) 402-0804

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
IL

Other

Enumeration date
06/14/2023
Last updated
06/14/2023
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