Individual
MRS. ELIZABETH JANE WINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
544 S. CORNELL, VILLA PARK, IL 60181
(630) 993-0100
(630) 993-1402
Mailing address
1032 SHADY LANE, GLEN ELLYN, IL 60137
(630) 858-0900
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
IL
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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