Individual
KETTY BURGOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1227 W DEVON AVE, CHICAGO, IL 60660-1403
(773) 359-3505
Mailing address
6427 N MAGNOLIA AVE, CHICAGO, IL 60626-5305
(773) 359-3505
(312) 489-8138
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150108430
IL
Other
Enumeration date
08/04/2023
Last updated
08/15/2023
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