Individual
ANGELA DIDOMENICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5290 WILLIAMS DR, ROSCOE, IL 61073-9222
(815) 324-0324
Mailing address
7247 MABELS WAY, LOVES PARK, IL 61111-5373
(815) 222-7986
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150006528
IL
Other
Enumeration date
02/14/2022
Last updated
02/14/2022
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