Individual
EVAN MICHAEL WILLMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
50 NORTHGATE INDUSTRIAL DR, GRANITE CITY, IL 62040-6805
(618) 877-4420
Mailing address
448 WYLIE DR, NORMAL, IL 61761-5405
(618) 512-1803
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.024489
IL
Other
Enumeration date
04/21/2022
Last updated
04/21/2022
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