Individual
OLIVIA UTHAIWAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10001 GRAND AVE, FRANKLIN PARK, IL 60131-2563
(847) 451-5342
Mailing address
10001 GRAND AVE, FRANKLIN PARK, IL 60131-2563
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
XOF822908659
BLUECROSS BLUESHIELD
IL
Enumeration date
01/16/2018
Last updated
01/16/2018
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