Individual
CONSTANCE VITALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
1250 PARK AVE W APT 430, HIGHLAND PARK, IL 60035-2253
(773) 315-3625
Mailing address
1250 PARK AVE W APT 430, HIGHLAND PARK, IL 60035-2253
(773) 315-3625
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
180-001120
IL
Other
Enumeration date
11/27/2006
Last updated
10/11/2023
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